With more than half of all women who reach age 50 in 2000 living to at least 80, lifelong oral health care is more important than ever.  Women's oral health is affected by their different stages of life.  For many women, these changes are directly related to changes in hormone levels, such as in puberty, menstruation, pregnancy, lactation and menopause.

Puberty-The surge in hormones that occurs during puberty may cause swollen gums, especially during menstruation.  Herpes-type lesions and ulcers also can develop.  Girls may experience sensitive gums that react more to irritants.

Pregnancy-Pregnant women have a risk for increased inflammation of the gums because of the surge in estrogen and progesterone.  If the plaque isn't removed, it can cause gingivitis-red, swollen, tender gums that are more likely to bleed.  And, women with periodontal disease may be at risk for pre-term, low-birth weight babies.  They are also at risk for developing pregnancy tumors- inflammatory, benign growths that develop when swollen gums become irritated.  Usually these tumors shrink soon after the pregnancy is over.  If a women experiences morning sickness, it is important to neutralize the acid caused by vomiting which causes tooth erosion.  Patients can use a paste made of baking soda and water, rubbing it on the teeth.  After 30 seconds, rinse off the paste, then brush and floss.  If this is not possible, rinse with water.

Oral Contraceptives-Oral contraceptives mimic pregnancy because they contain progesterone or estrogen.  Therefore gingivitis may occur with long-term use.  Use of certain antibiotics while taking oral contraceptives can decrease its effectiveness.  Women who use birth control pills are twice as likely to develop dry sockets and should consult their dentist before scheduling major dental procedures.

Menopause-During menopause, some women can experience dry mouth, burning sensation, and changes in taste.  Gums can even become sore and sensitive.  Hormonal replacement therapy may cause gums to bleed, swell and become red.

Aging Factors- Osteoporosis can lead to erosion of the jawbone.  Since teeth prevent the jawbone from eroding, once a woman begins losing teeth, the jawbone can lose its shape, which leads to difficulties with implants and dentures.  Ill-fitting dentures can lead to mouth sores and a loss of oral function, such as the ability to speak and eat.

Arthritis limits the mobility of the hands and face joints which affects the quality of brushing and extended care of the teeth, thereby compounding oral health concerns.

Other factors-Diet pills and certain medications (over-the-counter and prescriptions) can decrease salivary flow, which puts patients at risk for cavities, gum disease and discomfort.  Patients with eating disorders, such as bulimia (self-induced vomiting) can't hide their symptoms from their dentists because the episodes of binging and purging cause erosion on the backside of the upper front teeth.  (An additional sign is sores that appear at the corners of the mouth.)  Smoking also creates a higher risk for periodontal disease.

With a personal oral health regimen and trips to the dentist at least twice each year for cleaning and screenings, women can maintain a healthy smile for life.  Next week I will talk about other oral health concerns that women can face.