Menstruation gets blamed for cramps, back pain, bad moods, and chocolate cravings. But did you know that monthly hormone fluctuations also have a big impact on your oral health? If you’ve noticed that your time of month corresponds with increased gum sensitivity and symptoms of gingivitis (gum bleeding, red swollen gums, and oral sores) – you’re not wrong!
Some of my patients are surprised to learn how much hormone fluctuations can affect their oral health; but, starting as early as puberty, changing levels of sex hormones like progesterone and estrogen increase gum sensitivity and susceptibility to gum disease.
As levels of progesterone and estrogen increase during puberty, blood circulation increases. Greater circulation to the gums means higher sensitivity and susceptibility to irritation; it may also increase the growth of bacteria under the gumline.
During puberty, oral care should focus on daily brushing and flossing. If swelling occurs, seek out dental care; swelling caused by bacteria growth under the gums requires removal by a dental professional. After professional care, increased home care is essential – untreated, permanent bone and tissue damage can occur.
Feel like your gums are always sore or your teeth feel loose or slightly off during certain times of the month? You’re not alone. Many of my female patients report these symptoms and menstrual gingivitis is often the cause of the sensitivity they experience.
Sound familiar? Menstrual gingivitis (swollen, tender or bleeding gums, canker sores on the tongue and cheeks, or looser teeth) is caused by an increase in progesterone and estrogen levels which causes an increase in blood flow to the gums paired with a decrease in the body’s ability to fight off toxins, including plaque. Typically symptoms will show up a day or two before the period begins and end shortly after the period starts. If you are taking an oral contraceptive, you may notice increased symptoms.
Expecting a new bundle of joy? Congratulations! You have new gingivitis!
Pregnancy is another time women may notice increased gingivitis. Symptoms typically start in the second or third month and increase in severity until the eighth month before easing off. Often referred to as pregnancy gingivitis, it’s marked by increased swelling, bleeding and redness in the gum tissue.
Maintain a regular oral care routine, especially daily brushing and flossing, and take extra care of dental hygiene! You might benefit from visiting your dental office for professional cleaning more frequently during your second and early third trimesters. If tenderness, bleeding or swelling occurs, talk to your dentist as soon as possible!
Occasionally, inflamed gum tissue can form a large lump, called pregnancy tumours or granuloma. These non-cancerous growths are inflammatory responses to local irritants - food particles, plaque, or calculus that might be present. They typically look like a large lump with many deep red pin-point markings; usually painless, it can become painful if it interferes with your bite or debris is collected beneath it. Pregnancy tumours typically require professional treatment – either removal of local irritants followed by home care or further treatment as discussed with your dentist and doctor.
Pregnancy gingivitis and tumours typically diminish after pregnancy but do not go away completely; after pregnancy, visit your dentist for a full examination of your periodontal health. If you’ve already experienced swelling and bleeding prior to pregnancy, your chances of experiencing pregnancy gingivitis are higher; increased sensitivity due to high progesterone levels means your oral tissues are more likely to react strongly to local irritants.
Oral problems occurring during menopause typically aren’t related to hormonal changes; however, decreasing levels of estrogen can lead to dry mouth, chronic ulcers, sloughing of gum tissue, an abnormal taste sensation, and burning-mouth syndrome.
A rare condition called menopausal gingivostomatitis, marked by red and shiny gums that bleed easily, can affect some women. Other symptoms include a dry, burning sensation in the mouth, abnormal taste sensations (especially salty, peppery or sour), extreme sensitivity to hot and cold foods or drinks, and finally, difficulty removing any partial dentures. If you’re diagnosed with menopausal gingivostomatitis, your dentist or periodontist can help manage these conditions with medication.
Wondering what causes the effects of estrogen and progesterone on oral health? There are a few theories:
- High progesterone might cause oral mucosal tissue to swell, stimulate destructive bacteria growth, and suppress immune function. High progesterone levels may also reduce the tissue’s ability to repair itself due to hindered collagen production.
- High estrogen levels can increase metabolism and folate loss. Folate helps maintain healthy oral tissue. Fluctuating estrogen levels can also stimulate blood-clotting factor breakdown and decreases in estrogen can lead to osteoporosis in the jaw.
- Other hormone and chemical fluctuations can lead to further jaw troubles and dental disease.
If possible, schedule dental procedures and surgeries on days that you aren’t taking an estrogen pill – higher estrogen levels are more likely to lead to dry socket, a condition where the blood clotting and healing fails to occur after tooth extraction.