Garden State Woman Watch Your Mouth: Part I For Women Only by Dr. Allyson K. Hurley, DDS, MAGD, AAACD

Practicing good oral hygiene and seeing your dentist for regular check-ups is sound advice for everyone male or female, young or old. But women of all ages have particular oral health needs of which they need to be aware. The following are common issues women may experience throughout the different phases of their life, along with the oral health problems associated with them. Puberty When a girl reaches puberty, she experiences a surge in hormones that may cause gum tenderness, particularly when she menstruates. She may also develop mouth ulcers or lesions. Of course, this can make brushing and flossing uncomfortable or painful, which in turn may cause her not to brush and floss as thoroughly as she should, thus leading to gingivitis (inflammation of the gums) or periodontal disease. There are several over- the- counter products, including topical applications and lozenges, which can help relieve some pain caused by gum sensitivity and mouth ulcers. In addition, warm saltwater rinses and non-alcoholic mouthwashes may help. Bulimia Bulimia is an eating disorder often characterized by episodes of “binge” eating followed by purging via self-induced vomiting. Although it can affect men and women of all ages, it is more prevalent in women. Bulimia can lead to the erosion of tooth enamel due to the introduction of stomach acid into the oral cavity, which results in the insides of the teeth being worn away and an increase in tooth decay. The teeth can also become very sensitive. To address these problems, we make custom-fitted fluoride trays that allow the patient to apply fluoride to her teeth daily. We can also prescribe to such patients higher-concentration fluoride toothpaste to help prevent the devastating effects this condition can have on the teeth. The higher concentration of fluoride also seems to help decrease the tooth sensitivity that often accompanies this condition. Pregnancy Have you ever heard the saying that a woman loses a tooth for every child she bears? Of course, this is just an old wives’ tale. However as a result of hormonal changes, especially surges in the hormones estrogen and progesterone, pregnant women can develop several oral health problems. One of the most common is swelling of the gums, often referred to as “pregnancy gingivitis”. Pregnancy tumors, a benign but painful condition where growths form on irritated gum tissue, are another common problem. Both conditions can be reduced or eliminated by thorough, gentle brushing of the gum tissue, teeth, and tongue at least twice a day, in addition to daily flossing. Hormonal fluctuations can also lead to an increased buildup of plaque. Combined with the sensitivity and pain caused by swollen gum tissue, which may cause women to be less thorough in their oral hygiene regimens, periodontal disease may result. Since periodontal disease is not always a painful condition it can go undetected. Periodontal disease can lead to tooth loosening, tooth loss, and infection, which may also increase a woman’s risk of having a pre-term, low-birth-weight baby. Which smoking is another risk for delivering a premature baby. In addition, vomiting associated with morning sickness can cause erosion of the tooth enamel as stomach acid is brought into the mouth. This increases the risk of tooth erosion and cavities. Again, brushing and flossing at least twice a day, along with drinking plenty of water and using fluoride toothpaste can help protect the teeth. Oral Contraceptives Oral contraceptives contain progesterone or estrogen, so women using this form of birth control may experience some of the same problems as pregnant women, including gingivitis. Some studies have also found that women who use oral contraceptives are at a higher risk of developing dry sockets (a localized inflammation of the tooth socket) following a tooth extraction (in addition, certain antibiotics can negate the efficacy of oral contraceptives). If these antibiotics are prescribed for any reason, a back-up form of birth control should be used until the course of antibiotics is finished. For these reasons, it’s always a good idea for women who use oral contraceptives to let their dentists know. Menopause Due to further changes in hormone levels, women going through menopause often experience dry mouth. Also, many women at this phase of their lives are also on medications that can cause dry mouth as a side effect. This increases the chance of tooth decay, especially along the gum line and in between the teeth. In addition to drinking lots of water, brushing and flossing daily, and going to the dentist regularly, women with dry mouth can use a prescription fluoride toothpaste that can help prevent increased tooth sensitivity. Osteoporosis According to a study of 2500 postmenopausal women, low bone density (osteoporosis) led to an 86% greater risk of gum disease. Similarly, osteoporosis may also cause bone loss around the teeth. Dental x-rays can help identify potential problems before they become too serious. For more information on women’s dental health issues visit www.AllysonHurley.com or the Academy of General Dentistry’s website.