The links between fluctuating hormone levels and oral health in women are becoming clearer. Scientists and dental clinicians can explain why, during pregnancy and breastfeeding, women often complain about their gums and teeth feeling different, and why the mouth seems similarly “off” during menstruation. The good news is these conditions are entirely normal; they are caused by fluctuating hormone levels. Women tend to have more dental problems whenever their bodies are going through hormonal changes, from the onset of puberty to menopause. Why do hormones affect our teeth? Female hormones, oestrogen and progesterone, are critical to a woman’s oral health. The creation and circulation of female hormones causes more blood flows to the gums, making them tender and susceptible to the plaque and bacteria that accumulates around them. The gums can get inflamed and swollen, sometimes to the point of bleeding. A prolonged inflammation may even lead to gingivitis and periodontal disease, two of the most common, mild forms of gum disease. Menstruation If you’ve ever noticed swollen or bleeding gums during your period, or ulcers, or swollen salivary glands, hormones may be to blame. Puberty Similarly, female teenagers’ bodies are flooded with female hormones. The surge in estrogen and progesterone causes their bodies to mature, but it also increases blood flow to the gums, often leaving the gums red, tender, swollen, or worse case scenario, bleeding. Some teenage girls going through puberty may also find themselves developing canker sores, or ulcers. None of this is pleasant, but it is quite normal. Pregnancy Oral health needs particular attention during pregnancy. Teeth and gums are especially vulnerable to problems during this time. The reason again is hormonal: during pregnancy, women experience a significant boost in female sex hormones. In fact, women produce more estrogen during a single pregnancy than throughout the rest of their lives. This surge in hormones is designed to help ligaments relax and to improve the formation of blood vessels, all of which allows a baby to grow and thrive in the womb. It’s good for the baby, of course, but not for the gums, which are at increased risk of periodontal disease as a result. The problem is compounded by the fact that during pregnancy we have a reduced flow of saliva, whose natural antimicrobial and antiviral properties would normally help to protect the teeth and gums. To make matters worse, women often crave high-energy, sweet foods that pose additional threats to the teeth. Some women find they develop pregnancy gingivitis, especially between the second and eighth months of pregnancy— a mild form of gum disease that causes gums to be red, tender, and sore. Other women will find themselves getting cavities for the first time in their lives. Menopause During menopause, the female body also goes through major hormonal changes. Some women experience the uncomfortable feeling of dry mouth as the amount of estrogen and progesterone they produce decreases dramatically. Dry mouth happens when you don’t have enough saliva, and it can cause pain while eating, swallowing, or talking. Without enough saliva, the risk of cavities also increases. What can be done? There are some obvious and less-obvious solutions to hormone-induced oral health issues. First, maintain a thorough home-cleaning and hygiene regime: brush your teeth regularly and use floss and interdental brushes. Second, visit your dentist. This has become more difficult during the period of the pandemic, but dentists are best placed to advise on, and alleviate, any oral issues caused by hormonal changes. Third, and perhaps less intuitively, chew sugar-free chewing gum. Research by the Department of Dentistry at King’s College London in 2019 found that people who chew sugar-free gum develop 28% fewer cavities than those who do not. The equivalent figure for fluoride toothpastes and other supplements was 24%. Sugar-free chewing gum alleviates inflamed gums and dry mouth by stimulating saliva production by up 10 to 12 times the normal amount. This saliva neutralizes acid, soothes inflammation and rids the mouth of bacteria and plaque. Multiple studies show that good oral health means a healthy oral microbiome, which in turn translates into good overall health. This is even more pronounced during periods of stimulated hormonal change in women. This is normal and there are effective preventative measures to hand, such as home-care and sugar-free gum. These can alleviate symptoms and prevent to onset of more serious problems.