Although everyone should practice good oral hygiene, women have special dental health needs and considerations that can make them more prone to gum disease, tooth decay, and other dental concerns, especially during certain stages of their life as they body experiences hormonal changes.
During puberty, hormonal imbalances may cause the gums to become more sensitive to irritants, like food particles and plaque, causing the gums to swell, feel tender, and turn red. Some girls are prone to a temporary kind of “menstruation gingivitis” – bleeding or swollen gums – just before the onset of each period.
But hormonal gingivitis isn’t limited to only during periods. During pregnancy, women go through a fluctuation of estrogen, progesterone, and other hormones, which increases their risk for gum disease; a phenomenon known as “pregnancy gingivitis’. Other symptoms may appear during this time, including “pregnancy tumor” or pyogenic granulomas, which is a benign growth that causes swollen, painful, and bleeding gums, though it shrinks after the pregnancy.
So, it is critical that women, at all stages of life, practice regular and proper oral hygiene to reduce these symptoms.
What it is hormonal gingivitis?
Hormonal gingivitis is a specific type of gum disease that is characterized by inflammation of the gums that occurs as a result of hormonal changes, particularly during pregnancy or in women during their menstrual cycle. Depending on the period when it occurs, it can be referred to as either pregnancy gingivitis or menstruation gingivitis, respectively.
Hormonal gingivitis is highly prevalent during pregnancy, affecting 60 to 75 percent of pregnant women. It is typically caused by poor oral hygiene and local irritants, particularly plaque, causing an inflammatory response that is further exacerbated by hormonal and vascular changes during this period.
Symptoms of hormonal gingivitis
Here are some common symptoms associated with hormonal gingivitis:
- Swollen and red gums – Increased blood flow to the gums can cause the gums to appear swollen and redder than usual.
- Tender or sensitive gums – They may feel tender to the touch or become more sensitive to hot or cold temperatures.
- Bleeding gums – One of the hallmark signs of gingivitis is bleeding gums, especially when brushing or flossing
- Increased gum sensitivity – Gums may react more strongly to irritants like spicy foods or certain oral care products.
- Receding gumline – The gums may start to pull away from the teeth, causing exposure of the tooth roots and increased tooth sensitivity.
- Bad breath (halitosis) – The buildup of bacteria can contribute to persistent bad breath
- Increased pocket depth – Minimal loss of attachment (pseudopocket) may be observed
- Pregnancy tumors or pregnancy granulomas or pyogenic granulomas – They occur in up to 10 percent of pregnant women.
These symptoms of gingivitis often become more noticeable from the second month of pregnancy and peak in the eighth month, with the front areas of your mouth being affected earlier and more frequently than posterior areas.
These symptoms may vary in severity and can come and go with hormonal fluctuations. If you notice them, it’s recommended that you consult with your dentist, or healthcare provider if pregnant, for a proper diagnosis and appropriate treatment
Treatment options for hormonal gingivitis
The severity of hormonal gingivitis tends to decrease after childbirth, though the gingiva may not fully return to its pre-pregnancy condition.
Depending on your specific case of hormonal changes you’re experiencing, your dental or health professional will provide personalized guidance and recommend specific strategies to manage hormonal gingivitis effectively.
Some common treatment options include:
The quality of the diet plays a significant role in the development of dental caries and pregnancy gingivitis. Proper nutrition is crucial not only for the overall health of the mother but also for the developing dentition of the fetus. Pregnant women often receive nutritional guidance from their obstetricians, and it is important for the dental team to reinforce the importance of a healthy diet.
Certain nutrients are particularly important during pregnancy to support optimal oral health, including vitamins A, C, and D, protein, calcium, folic acid, and phosphorus. These nutrients contribute to the formation and maintenance of strong teeth and gums. Pregnant patients should ensure that their diet provides sufficient levels of these essential nutrients.
When it comes to snacking, it is advisable to limit the number of times pregnant patients snack between meals. Many foods contain sugars and starches that can contribute to the development of dental caries. Frequent snacking can expose the teeth to prolonged periods of acid attack, increasing the risk of tooth decay. Instead, patients should focus on selecting nutritious snacks that are low in sugar and starch content.
By following a balanced and nutritious diet, pregnant women can support their oral health and minimize the risk of dental caries and pregnancy gingivitis.
During pregnancy, it is essential to maintain a good plaque control program to minimize the exaggerated inflammatory response of the gingival tissues. Pregnant patients should be informed about the connection between hormonal changes and gingival inflammation, so they understand the need for effective oral hygiene techniques.
Dental professionals can provide guidance on proper brushing and flossing techniques that are safe and effective during pregnancy. Regular monitoring and reinforcement of oral hygiene practices throughout pregnancy can help ensure that the patient maintains good oral health.
Here are some tips for optimal plaque control:
- Be consistent – Brush your teeth at least twice a day using a soft-bristled toothbrush and fluoride toothpaste. Floss daily to remove plaque and food particles from between your teeth and along the gumline.
- Use an antibacterial mouthwash – Rinse your mouth with an antibacterial mouthwash to help reduce the bacteria that contribute to gum inflammation. Choose a mouthwash that is alcohol-free and specifically designed for gingivitis.
- Practice gentle gum care – Be gentle when brushing and flossing your teeth to avoid further irritation to your gums. Use a toothbrush with soft bristles and avoid aggressive brushing or scrubbing motions.
- Schedule regular dental cleanings – Visit your dentist regularly for professional cleanings. Dental cleanings can remove plaque and tartar buildup that can contribute to gingivitis. Your dentist can also provide personalized advice on preventing hormonal gingivitis, especially during pregnancy.
Scaling, polishing, and root planning
This may become necessary in the event that periodontal disease is diagnosed, in order to address the periodontal infection. These procedures involve the thorough cleaning of the teeth and gums to remove plaque and calculus buildup, reducing inflammation and promoting gum health.
This kind of dental work is considered safe during pregnancy and can contribute to reducing the inflammatory response caused by periodontal infection.
Prenatal fluoride treatment
Prenatal fluoride supplementation is considered safe for both the mother and fetus in cases where the fluoride levels in water are less than 0.3 parts per million (ppm F). However, it is crucial to consider individual circumstances and consult with healthcare professionals, including dentists and obstetricians, before making decisions regarding prenatal fluoride supplementation.
Hormonal changes can also be brought about by increased stress levels, worsening your case of gingivitis. Consider practicing stress management techniques such as deep breathing exercises, meditation, or engaging in activities you enjoy to help in stabilizing your hormones.
How to clean your mouth when suffering from gingivitis
If you notice the signs of hormonal gingivitis, it’s important that you make attempts to improve your oral hygiene, which includes brush your gums and teeth properly, in order to help alleviate the condition.
Here are some tips for brushing your gums effectively:
- Choose a soft-bristled toothbrush that is gentle on your gums. Hard bristles can further irritate inflamed gums.
- Apply only light pressure while brushing to avoid causing further irritation to your gums. Aggressive brushing can damage the gum tissue and worsen gingivitis.
- Tilt your toothbrush at a 45-degree angle towards the gumline. This allows the bristles to reach the area where the gums meet the teeth.
- Brush in small, circular motions, instead of using vigorous back-and-forth strokes, when cleaning the gumline and the surfaces of your teeth. This helps remove plaque and bacteria without causing harm.
- Pay attention to every tooth, take your time (at least 2 minutes), and be thorough.
- Gently scrape or brush your tongue to remove bacteria that can contribute to gum inflammation.
- After brushing, rinse your mouth with an antibacterial mouthwash or warm saltwater solution to further reduce bacteria and soothe your gums.
- Thoroughly rinse your toothbrush with tap water to remove any remaining toothpaste and debris. Then soak the toothbrush in saltwater for 15 minutes to disinfect it.
Lastly, be consistent in your oral hygiene routine. Brush your teeth at least twice a day, ideally after meals, and continue to maintain good oral hygiene habits.
In most cases, hormonal gingivitis is usually temporary and resolves after hormonal fluctuations stabilize. However, it’s essential to address it promptly to prevent it from progressing to more severe forms of gum disease (periodontitis) that may lead to infections or even tooth loss.
So if you notice the symptoms of hormonal gingivitis, make sure to inform your dental or healthcare professional for a proper diagnosis of your condition, after which they can recommend treatments or adjustments to your oral care routine to help address the problem.
Collaborative efforts between the patient and dental professionals play a crucial role in achieving and sustaining oral health throughout this period.