Women and Periodontal Disease

Three of four adults are affected by periodontal disease, which is commonly known as "gum disease," at some point in their lives. Women are especially susceptible to periodontal disease at certain stages of life. Hormonal changes can affect the blood supply to the gingivae (commonly called "gums"), and response to irritants from plaque may be exaggerated. If you already are prone to periodontal disease, you may find the problem worsening at these times. We'll discuss those times, but first let's examine what causes periodontal disease.

THE CAUSE OF PERIODONTAL DISEASE
Periodontal disease is an infection of the gums and bone caused by plaque, a sticky film of bacteria that adheres to teeth. Plaque forms constantly on teeth and can build up if it is not removed through daily cleaning. The bacteria in plaque produce toxins, or poisons, that can irritate your gums. In the early stage of periodontal disease, called "gingivitis," the gums swell, turn red and bleed easily. Eventually, the body's response to these toxins causes the gums to separate from the tooth and form deepened spaces called "pockets." In later stages of periodontal disease, called "periodontitis," the bone and soft tissues that support the teeth can be destroyed, which ultimately can cause the teeth to become loose, fall out or require removal by a dentist.

PERIODONTITIS THROUGH THE LIFE CYCLE
The teen-age years. As girls reach puberty, the production of the sex hormones progesterone and estrogen increases. This hormonal increase can exaggerate the way gum tissues react to the irritants in plaque. Gums may become red, tender, swollen and likely to bleed easily during chewing or toothbrushing.

The monthly cycle. During menstruation, some women do not notice any changes in their mouths at all. Others may experience swollen gums, lesions, canker sores, swollen salivary glands or bleeding gums in the days before the period begins. Your dentist may prescribe special cleanings, gum treatment or topical anesthetics to ease any discomfort.

Use of oral contraceptives. A common problem for women who take oral contraceptives, or birth control pills, is inflamed gums. The hormone in oral contraceptives increases the level of progesterone in your system. Tell your dentist if you are taking oral contraceptives, not only because they may cause any gum inflammation you might be having but also because some medications the dentist might give you, such as antibiotics, can lessen the effect of an oral contraceptive.

Pregnancy. During pregnancy, your body's hormone levels rise considerably. Gingivitis, especially common during the second to eighth months of pregnancy, may cause red, puffy or tender gums that tend to bleed when you brush. This sensitivity is an exaggerated response to plaque and is caused by an increased level of progesterone in your system. Your dentist may recommend more frequent cleanings during your second trimester or early third trimester to help you avoid problems.

Menopause. Physical changes that can occur in the mouth when you reach menopause include a burning sensation, altered taste sensations (salty, peppery or sour), a decrease in salivary flow that can result in dry mouth, and greater sensitivity to hot and cold foods or drinks. Many medications (both prescription and over-the-counter products) can have dental-related side effects, including dry mouth. Saliva substitutes may be prescribed to reduce any mouth dryness.

PREVENTION
There are ways you can help prevent periodontal disease.
- Be sure to brush your teeth thoroughly twice a day and clean between your teeth daily with floss or interdental cleaners. Choose oral care products that carry the American Dental Association Seal of Acceptance, which is your assurance that a product has met ADA criteria for safety and effectiveness.
- If you need extra help in controlling plaque and gingivitis, your dentist may recommend that you use an antimicrobial mouthrinse.
- Visit your dentist regularly for examinations and professional cleanings.
- Eat a balanced diet for good general health and limit your snacks.

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