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Women’s Oral Health: Reproductive Issues

As with most health-related issues, medical science is discovering that females have special dental needs, especially when it comes to puberty, menses and pregnancy.
“While it was once assumed there were no differences between treating male and female patients, we are finding as we have in other areas of health, that women have  special needs when it comes to oral care,” says Dr. Eve Brown, a Cary, N.C., dentist.
The early onset of puberty in women during which sex hormones estrogen and progesterone are released can directly affect oral health. “Girls are experiencing puberty at an earlier age,” says Dr. Brown, “ so we seeing an increase in related dental issues in young women and even children.”
Studies show that gingivitis, or inflammation of the gums, can be related to increased  hormone levels with the onset of puberty. “Patients experience changes in gum tissue, including microbial changes, that help some species of bacteria to flourish in the mouth during puberty,” says Dr. Brown. “This can result in inflammation and bleeding. Fortunately, these cases respond well to a vigorous program of good oral health and hygiene, as well as careful attention by a dentist.”
Similarly, the menstrual cycle can result in swollen or tender gums, even bleeding. Herpes infection is also possible. “Local preventive care is important in these cases and dentists can recommend effective treatment when they occur.” There are more than 6 million pregnancies each year in the U.S. according to the Centers for Disease Control (CDC) and  pregnancy can give rise to a  number of special oral health issues, and also several old wives tales.
“There is no clinical evidence that the old statement ‘a tooth loss for every child’ is true. Calcium in teeth is stable and there’s plenty in the mother’s bones to supply the needs of the fetus.”Likewise, there is little evidence that pregnancy contributes to additional cavities. “Pregnancy does cause an increase in appetite and often a craving for unusual foods,” says Dr. Brown. “If these cravings lead to intake of foods high in sugar content, then there could be an effect on oral health, but pregnancy, itself, does not cause more cavities.”One  rare side effect of pregnancy is acid erosion of teeth associated with repeated vomiting due to morning sickness or esophageal reflux. “We instruct women to rinse their mouths frequently with water to remove acid when this occurs,” says Dr. Brown
Gingivitis during pregnancy is fairly common and  occurs in 60-75% of pregnant women reports Dr. Brown. “This gum inflammation and bleeding  is most common from the second month of gestation and peaks around the eighth month. It’s reduced after childbirth.”
Dr. Brown also notes that some pregnant women may experience tumor-like growths in the gums. “Even this happens rarely, in only about 10% of pregnancies, and can be prevented with good oral hygiene.”
Other, minor dental conditions may also occur during pregnancy, including generalized tooth mobility, dryness of the mouth, and excessive secretion of saliva.“The bottom line is that pregnant women should pay close attention to their oral health and involve their dentist in preventive care programs in concert with the care they receive from their obstetricians,” advises Dr. Brown. “We advise expectant mothers to eat well, including a diet with sufficient levels of vitamins A,C and D; protein; calcium, folic acid and phosphorus. Also, they should choose healthy snacks and limit between-meal-snacking as much as possible.”
Dr. Brown also recommends a good plaque control program and regular dental visits. “Elective dental care should be timed to occur during the second trimester and the first half of the third trimester, when the fetus may be less sensitive to environmental influences. Extensive reconstruction and major surgery should be postponed until after delivery,” advises Dr. Brown. “Patients should also pay attention to medications they take that might affect the fetus.”
Dental X-rays may be needed for dental treatment or a dental emergency before the baby is born. “Since untreated dental infections can pose a risk to the fetus and to the mother and the risk of dental X-rays is extremely low, it’s usually best to proceed with treatment if needed,” says Dr. Brown, adding that precautions can be taken in the dental office to minimize fetal exposure to radiography.
Additional information on oral care for women can be found by visiting or The N.C. Dental Society represents 3,600 dentists throughout North Carolina. The NCDS encourages improvement of the oral health of the public, promotes the art and science of dentistry, sustains high standards of professional competence and practice, and represents the interests of the members of the dental profession and the public which it serves.