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The Effects Of Hormonal Changes On The Periodontium
By Dr. Anasinski

The periodontium is the part of the mouth that is made up of teeth, gums and supporting structures:

Gingiva – Your gum
Sulcus – The space between your tooth and gum
Cementum – The root surface of your tooth
Pulp – The center of your tooth root
Connective tissue
Bone

Keeping the periodontium healthy affects overall health and conversely, changes in a person’s overall health or body can affect the periodontium. Women are particularly susceptible to periodontal problems because of the fluctuating hormones that they experience throughout their lifetime. In fact, studies show that about seventy-five percent of periodontal office visits are made by women even though in general they take better care of their teeth than men. The reasons behind this statistic are that female hormones affect the gums and make them susceptible to gum disease, particularly during pregnancy and during and after menopause.

Hormonal changes from pregnancy do not cause gum disease, but will aggravate any existing periodontal issues. During pregnancy elevated serum progesterone can aggravate existing gingivitis and cause problems from even a small amount of plague. Gum disease is not an issue for all pregnant women, but when it does occur, it is most evident in the second or third trimester and if it is pregnancy-related gingivitis, usually resolves within a few weeks of delivery. Because periodontal disease has been associated with the risk for low birth-weight babies and other complications, good oral hygiene and visits to the dentist or Periodontist during pregnancy are extremely important.

Since during menopause, women experience a decrease in their levels of estrogen and progesterone, problems with the periodontium can occur at that time as well. Because the loss of estrogen reduces bone mineral density, it can lead to bone loss from either periodontal disease or osteoporosis which manifests in oral discomfort. Some women who are experiencing menopause develop a rare condition called menopausal gingivostomatitis that results in gums that are dry, shiny and susceptible to bleeding. There is also a direct link between a lack of estrogen and osteoporosis, which is often called the “silent disease” because bone loss can occur without any symptoms. And bone loss in the alveolar bone which holds teeth in place can be a direct cause of tooth loss in post menopausal women. Estrogen supplements may reduce the risk of bone loss or damage from osteoporosis, but good dental care and oral hygiene can help reduce the possibility of periodontal problems that can increase susceptibility to bone loss in the periodontium.

Studies have shown that periodontal diseases may be linked to other health risks such as cardiovascular disease, diabetes and Alzheimer’s. Therefore detecting and healing infections and inflammations of the gum can be imperative in caring for overall health.

Because hormonal fluctuation is most extreme during pregnancy and menopause and fluctuating hormones have been shown to have direct and indirect effects on oral health, women in either of these stages of their lives are more susceptible to periodontal disease. Good at-home oral hygiene and regular visits to the dentist or Periodontist are always an important part of good oral health which contributes to good overall health, but for women, they are extremely important during pregnancy and menopause.

Kind regards,

Dr. Anasinski