Dr Gautam Sharma
Throughout a woman’s life, hormonal influences affect dental tissues, especially the gingiva (gums) which is part of the periodontal structure. Hormonal changes increase the risk of periodontal disease. Therefore, it becomes extremely important for a dentist to recognize and treat the patient with proper therapy. The specialist who treats periodontal disease, including gum and alveolar bone problems, is known as a periodontist.
Puberty Gingivitis is seen in girls in the age group of 11 to 14 years and is due to the increase in the levels of estrogen and progesterone hormones. There is increased blood flow to the gingiva (gums), increasing their sensitivity and reaction to local irritants. The gums become red, enlarged and bleed easily when brushing or even eating. To avoid inflammation of the gums, brushing twice a day to remove plaque is necessary. If bleeding gums are present, a visit to the periodontist is a must to clean the teeth and the procedure is known as scaling. It is a painless procedure and may require one to two visits. Bleeding gums can be completely controlled by scaling, but twice-daily brushing is of utmost importance, even after scaling. An antimicrobial mouthwash may be prescribed to control the growth of bacterial plaque on teeth and other oral tissues.
During menstruation, hormones that are increased include follicle stimulating hormone (FSH), estrogen, and progesterone. These hormones increase the inflammation of the gum tissues and exaggerate the response to local irritants thus causing the gums to bleed, sometimes a burning sensation in the mouth may be present. Treatment is similar to that given for pubertal gingivitis. In case of gum overgrowth, a surgical procedure called a gingivectomy may be necessary. In this, the periodontist removes excess gum tissue so that the patient can maintain oral hygiene by brushing their teeth to control the deposition of bacterial plaque.
Pregnancy gingivitis, as the name suggests, is seen in many women during pregnancy and is clinically manifested by red, enlarged gum tissues that bleed even when the gums are touched. The level of hormones (estrogen and progesterone) is much higher during pregnancy, which leads to an exaggerated response of the gums to local irritants, in particular. bacterial plaque. Sometimes tooth mobility can also be present during pregnancy. A growth-like tumor known as a pregnancy granuloma that looks like a mushroom and protrudes from the gum line between the two teeth can sometimes be present. He bleeds easily on stimulation or touch.
During pregnancy, the mother’s immune response is diminished in order to protect the developing fetus from any strong immune reaction. The number of pathogenic bacteria is also increased in the subgingival plaque due to the increased level of hormones discussed above, so it becomes very important to maintain good oral hygiene during pregnancy and visiting a doctor. periodontist for oral prophylaxis is mandatory.
It is a scientifically established fact that untreated periodontal disease during pregnancy can be a significant risk factor for preterm labor and low birth weight babies. This is due to the presence of pathogenic bacteria in the gums of the mother which can be transmitted through the blood to the amniotic membrane of the fetus and an inflammatory response can cause premature rupture of the amniotic membrane thus leading to premature or early birth of the fetus. baby who would have a low birth weight.
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during her pregnancy. This may be due to an increased incidence of periodontal disease during pregnancy, which can interfere with insulin function.
Menopausal gingivostomatitis is seen in women in the age group of 45-55 years. This condition is due to the deficiency of estrogen hormone. This condition is characterized by a dry, burning mouth with pain and altered taste, gum recession is also a common feature.
Management of all the conditions mentioned above can be done by maintaining good oral hygiene by brushing twice a day with a soft-bristled toothbrush, flossing and rinsing with a mouthwash such as prescribed by the dentist. A visit to a dentist every six months for a regular check-up is mandatory. In case of bleeding gums, mobility of teeth, bad breath from the mouth or gum recession, it is advisable to consult a specialized dentist, i.e. a periodontist. During pregnancy, a complete oral check-up is mandatory to avoid any complications during pregnancy. A simple procedure like tooth scaling can remove bacterial deposits from the teeth, which is necessary to keep the mother and developing fetus healthy. Self-medication to treat dental disease can be dangerous, especially. during pregnancy, therefore, always consult an expert dentist before consuming any medication. The role of a healthy and balanced diet cannot be overlooked in boosting and maintaining oral and general health.
(The author is a Periodontist at the University of Jammu and is also the Past President of the Indian Dental Association, Jammu)
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