Women’s Special Dental Needs

Publication: Montana Woman Magazine

Men and women are not the same. Most dental principles apply to either sex and there are many special considerations for our female patients. I will review a few of these this month. We all know the body’s systems are interconnected, but few of us recognize that the health of a woman’s smile is strongly influenced by hormones, and may be an indicator of overall cardiovascular and systemic health. Most systemic diseases have oral symptoms. Educating consumers on the link between oral and systemic health can save lives!!

The link to systemic health has been recent news as researchers have discovered that oral health scores were a stronger predictor of heart disease risk than well studied factors like cholesterol levels! Diabetes mellitus increases risk and susceptibility for gum disease.75% if adults over 35 have some degree of gum disease. Somewhere between 3 and 5 hundred species of bacteria are found in the mouth and they multiply 36 times while you are sleeping. Uncontrolled, the body’s immune system may be overwhelmed or over stimulated resulting in damage to the oral tissues and systemic ramifications such as blood sugar problems or sepsis. Good nutrition and hygiene become important in maintaining a healthy balance.

The ebb and flow of hormones during a woman’s life may affect her response to plaque, the sticky bacterial film responsible for most dental woes. Changes in estrogen and progesterone that occur during puberty put young women at greater risk for gingivitis. In younger women, dentists are also on the lookout for signs of bulimia, which is terribly destructive to enamel. Monthly fluctuations of menstruation also make some women more prone to gingivitis, canker sores, cold sores, and swollen salivary glands. Birth control pills can increase the risk of bleeding gums, dry mouth and dry sockets. Some antibiotics have been suspected of decreasing the effectiveness of oral contraception, so it is wise to check with your doctor or pharmacist when taking drugs to fight infection.

Pregnancy gingivitis occurs in 60-75% of women between 2 and 8 months due to the rush of progesterone. Good hygiene and preventative measures are important at this time. Most dental procedures can be safely performed on pregnant women, but take extra special caution during the first trimester while the little one is forming .It is important for expectant mom’s practice good hygiene for her and her child’s benefit. It is also true that decay causing bacteria can be passed to small children from us, once they have teeth!

At menopause, when hormone levels decline, other oral changes may occur. Burning mouth syndrome, dry mouth, altered taste perception and osteoporosis are not uncommon. Hormone replacement therapy may ease these symptoms. Bisphosphonate drugs used to treat osteoporosis and some cancers (breast), have recently been associated with severe bone necrosis (large portions of bone may die and slough) in the jaws. Before you undergo surgical procedures in the mouth, alert your dentist about the drugs you are taking, especially if they are intravenously administered for cancer therapy.

Xerostomia or dry mouth can be a result of physical changes or drug side effects. In severe cases a change in medication may be indicated. Products by Biotene, such as the mouthwash Oasis help relieve the discomfort associated with dry mouth. Saliva is a very important lubricant, full of minerals and enzymes to maintain the enamel fight bacteria and aid digestion and swallowing. Without it your teeth are sitting ducks for decay and gum disease bacteria. Be sure to let your dentist know if you are experiencing problems, and often your dentist will notice before you do!

Many other health conditions have oral signs that your dentist may notice. Since many folks don’t see a doctor regularly, a heads up from the dentist can be valuable. Diabetes, vitamin deficiency, anemia, leukemia, and oral cancer are a few examples. New technology is currently being developed to use saliva tests to check for markers of many conditions, including HIV and cancer .I think these will become widely available in the next few years.

Common sense and good hygiene is the mainstay to keep your teeth at their best. This is the key; we can never recover to the original state of health once infections damage our oral tissues. I had to say this sooner or later, prevention is the best treatment there is! Whew, I feel better now.