Some rites of passage are obvious: Baby's first tooth, the first visit from the Tooth Fairy, getting braces. But periodontal disease? For a woman especially, gum disease tends to creep in at three key points in life: Menstruation, pregnancy and menopause.
First, a moment to explain what periodontal disease is: It starts with plaque, a soft, sticky buildup of bacteria. The longer it lingers, the more irritation it causes. That irritation can lead to gingivitis, which brings redness, inflammation, bleeding and tenderness in the gums. When gingivitis is left untreated, the gum tissues begin to separate from the tooth and form pockets. That's a sign of periodontitis. The pockets become infected, and can eventually break down the tissues that hold teeth in place.
Major hormonal shifts can compromise gum health. A report from the University of Maryland explains how:
- Menstruation: The hormone progesterone peaks a few days before menstrual bleeding, and sometimes at ovulation. Progesterone tends to increase blood supply to the gums, and change how the body responds to plaque. If you're using birth control, check to see how much progesterone is in the mix. Gingivitis could be a side effect.
- Pregnancy: It's critically important to see a dentist while you're pregnant, and here's why: There have been studies which linked gum disease to pre-term delivery and other complications. It's important to take care of any sign of gum disease early, and there are treatment options that won't compromise the pregnancy. During those nine months, the gums become progressively more irritated from the second month to the eighth month. Most of the time, pregnancy-caused gingivitis will calm down a few months after delivery, although it may last longer, especially if you're nursing.
- Menopause: Low estrogen levels impact bone density. A 2012 study found that women with low bone density were twice as likely to have periodontal disease. Also, a lack of saliva - dry mouth is common among menopausal women - can also increase the risk of gum infections.
So what's a girl to do? Brush, floss and visit your dentist and hygienist. Don't skip regular dental cleanings. Often it’s wise to be seen for teeth cleanings more often during pregnancy; perhaps every 3 months. Stop smoking. Make note of when your gums are more sensitive or red, and don't hesitate to call when you have a question or concern.
Peter J. Samuels is a Gettysburg dentist and a clinical instructor at the University of Maryland School of Dentistry.