Episode Transcript
Dr. Jones: We all know that women's mouths are different than men's. They move more, and they wear lipstick. But inside the lipstick, there are important differences. This is Dr. Kirtly Jones from Obstetrics and Gynecology at University Health Care and we are talking about women and oral health today on The Scope.
Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.
Dr. Jones: Women's hormones are different than men's. Women get pregnant. Women go through menopause. And some autoimmune diseases are more common in women than men. Of course, these are only a few of the differences between men and women. But all of these factors can affect teeth and the skin inside your mouth called the oral mucosa. Let's think a little more about how these factors affect women's oral health and what should we do about it.
One, boys and girls go through puberty, but the estrogen and progesterone that are part of puberty in girls causes increased blood flow to the oral mucosa. This may cause swelling and greater reaction to irritation caused by food particles. An 11-year-old girl can have perfectly fine teeth and gums even though she is not religious about brushing and flossing. After puberty, though, these bad dental habits may lead to swollen and bleeding gums. Hormones may also cause changes in the normal bacteria in the mouth.
So what to do? At the time that kids are the least likely to listen to you, you need to tell them about brushing and flossing. You might remind them that the red, swollen gums are unattractive and can cause bad breath. That might get their attention and it might get your girl on the program. If your daughter hasn't been to the dentist or the hygienist recently, maybe puberty is a good time to get a checkup.
Two, the same changes in the gums that happen in puberty can be exacerbated in the menstrual cycle. So some women notice more gum swelling in certain times of their cycle and some viruses like oral herpes or other oral ulcers may be more common just before the period. These actually may be flattened out in women who use hormonal birth control because it blocks the ups and downs of hormones, but that's just a little aside.
Three, pregnancy and the high estrogen hormones that causes even more swelling of the gums and bleeding gums is caused by gingivitis and it happens in about 60 to 75% of pregnant women. For some women the food they eat as part of their food cravings like sweets and ice cream before bedtime, and not brushing and flossing before you go to bed, can lead to changes in their oral health. Brushing and flossing are even more important in pregnancy as gingivitis and poor oral health causes inflammation throughout the body and is associated with an increased risk of preterm birth. I know, the last thing you want to do before you go to bed is belly up your big tummy to the sink, and brush and floss, but you have to go for it. And if the problem is more than you can handle, you should see your dentist.
Four, menopause is when the ovaries stop making so many hormones so your mouth should get better, right? Well, at menopause women suffer more than men of the same age from something called xerostomia; starts with an X as in xeriscape or dry gardening. The fancy word xerostomia means dry mouth. This can be just annoying or it can cause a burning sensation, a loss of taste, as well as needing to drink fluids all the time with the consequent potty trips. If this is happening to you, it may just be menopause, or it can be a number of other diseases including diabetes, or it could be your medications.
Talk with your clinician and your dentist about it. There are some simple things to help: avoid alcohol, caffeine, sodas, alcohol-based mouthwashes. There are some treatments your dentist can suggest, but it is important that you brush and floss regularly because having less moisture in your mouth means your teeth and gums aren't naturally rinsed as often. Sugarless lozenges that stimulate the salivary glands can be helpful.
Lastly, there are some autoimmune diseases that are more common in women than men that can affect the skin of the mouth. Sjogren's syndrome specifically causes dry eyes and dry mouth. This disease is more common as women age so it's hard for you to know what might be going on if you're suffering from dry eyes and dry mouth, both of which are more common after menopause. So you should bring up your symptoms with your clinician and they can help figure it out and give you some tips.
So ladies, watch that pretty mouth, take care of yourself and stay tuned as we'll be talking more about women and dental health in the future Scope radio sessions.
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