Periodontal Disease: A Woman’s Life Cycle Any woman knows that throughout her life her body will go through many different changes as she grows. What many women don’t realize is that their dental health plays a large part in their overall life time health. As you mature and change, so do your oral health needs. Though studies have shown that women tend to have better home care habits than men, hormonal fluctuations tend to even out the playing field. Because periodontitis (an advanced state of periodontal disease in which there is active destruction of the gum tissues) is often a “silent disease”, many woman are not aware of it until it reaches an advanced stage. The good news is, at each stage is your life, through awareness and good home care habits, you can safe guard your oral health. The Teenage Years: As a young woman’s body matures, her body begins to produce more sex hormones, namely progesterone and estrogen. This can increase the gum’s reactions to irritants such as plaque and food particles. As she matures, the tendency for her gums to swell in response to irritants will lessen. During this time, the best way to ensure long term dental health is to follow a good home care regiment, including daily brushing and flossing, and to see your dentist and hygienist on regular basis. The Monthly Cycle: During the menstrual cycle, many women notice no change at all in their mouths. Others may experience bleeding gums, red and swollen gums and sores on the inside of their cheek. This is called menstruation gingivitis, and generally occurs at about the same time as premenstrual syndrome. Once the cycle begins, the symptoms clear up. Pregnancy: During pregnancy many hormonal changes occur in a woman’s body, namely an increase in estrogen and progesterone (the same hormone that causes “morning sickness”). Pregnancy gingivitis may begin in the second month and increase in severity through the eighth month. Symptoms of pregnancy gingivitis include swelling, bleeding (“pink toothbrush”) and redness of the gums. Pregnancy gingivitis occurs because the elevated hormone levels exaggerate the body’s response to plaque and other irritants. It is important to note that pregnancy gingivitis is a hormonal response and may occur despite the most vigorous home care practices. The best way to combat pregnancy gingivitis is to continue to be diligent with both home care and dental appointments. Some pregnant women’s gums swollen by pregnancy gingivitis can react so strongly to irritants that they form large lumps called “pregnancy tumors”. These tumors are benign and usually painless. If the tumor persists after delivery, it may require removal by a periodontist. Periodontal disease can also effect the health of an unborn baby. Recently, research has linked periodontitis to premature birth and low birth weight. In fact, a pregnant woman who has periodontal disease is seven times as likely to have a baby born too early and too small. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. As always, any infection is a cause for concern in pregnancy. All pregnant women should receive a periodontal exam as part of their prenatal care. Oral Contraceptives Studies show that oral contraceptives such as the pill are the leading method of birth control among sexually active women. Oral contraceptives also increase the progesterone in your system, which can lead to inflamed gums. Some medications prescribed by your dentist for periodontal disease can reduce the effectiveness of oral contraceptives, so be sure to let your dental team know if you are taking them. Menopause and Post Menopause Women going through menopause or post-menopause may experience changes in their mouth. They may notice discomfort from pain and burning sensations, dry mouth and altered taste; which can be salty, peppery or sour. Menopausal gingivostomatitis also affects a small percentage of menopausal women. Some symptoms include gums that appear shiny and dry, gums that bleed easily and appear either pale or deep red. Estrogen supplements are known to help these conditions. Additionally, bone loss is associated with both periodontal disease and osteoporosis. In fact, alveolar bone loss (the bone that holds the tooth in the mouth) is the strongest predictor of tooth loss in post menopausal women. The risk of tooth loss increases 2.5 times for each millimeter of soft tissue attachment between the tooth and alveolar bone. This bone loss condition is associated with estrogen deficiency after menopause. Estrogen deficiency can result in a loss of bone mineral density, which can increase the chances of bone loss. Women considering Hormone Replacement Therapy (HRT), should consider that this may help to safeguard their teeth as well as other vital systems of their body. So What Can You Do? Awareness is the best defense, some ways to keep up on your oral health are:  See your dentist at least twice a year for exams and cleaning.  Maintain excellent home care. Brushing your teeth and flossing daily reduces the risk of irritants in your mouth and greatly improves your overall oral health.  If you or your dentist notice problems with your gums, begin seeing a periodontist (gum specialist). These are some symptoms to watch for:  Bleeding gums while brushing  Red, swollen or tender gums  Gums that have pulled away from teeth  Persistent bad breath  Pus between teeth and gums  Loose or separating teeth  A change in the way your teeth fit together when you bite A change in the fit of your dentures. If you would like any further information or would like to schedule a periodontal examination, please call our office on 01342 325522. My Brilliant Smile Dental And Facial Aesthetic Centre Yew Tree Lodge, 2 Green Hedges Avenue, East Grinstead, West Sussex, RH19 1DZ England www.mybrilliantsmile.com