Hormonal changes occur throughout a woman’s life. During certain stages, she may have special oral health needs. Puberty, menstruation, pregnancy, menopause and oral contraceptives (birth control pills) can have an effect on a woman’s mouth.

Puberty. During puberty, sex hormones (estrogen and progesterone) cause a female’s body to mature. In addition to the visible body changes, the sex hormone increase can change the way the gums respond to germs (bacterial plaque) in the mouth. The gums can become more susceptible to infections (gingivitis) and may become very red and swollen, and they can bleed a lot.

Menstruation. The oral concerns associated with the onset of puberty are much the same during the menstrual cycle. Occasionally, women who are prone to canker sores and cold sores may develop a pattern where these sores recur during every menstrual cycle.

Pregnancy. Gingivitis is the most common oral condition associated with being pregnant. It occurs in close to 60 percent to 75 percent of all women who are pregnant. As during puberty and menstruation, the increase in hormones exaggerates the gum tissue’s response to bacterial plaque. In addition to the overall gum changes, one area of the gum (usually between the teeth) may swell and produce what is called a “pregnancy tumor.” Often times, this area is enlarged, dark red or bluish in color, and is difficult to keep clean. Generally, the tissue will decrease in size after the birth of the baby, but sometimes the tissue may need to be removed by a dentist.

Often times, women will avoid dental checkups for fear that treatment might harm the baby. Untreated decayed teeth put a mother and her baby at risk for infection. For example, researchers have found a link between periodontal (a certain type of gum disease) and preterm low birth weight babies. One recent study suggests that women who have periodontal disease are at a 7.5 times higher risk for delivering preterm low birth weight babies than women who do not have periodontal disease. Therefore, it is extremely important that an expectant mother have a healthy mouth and see a dentist early in her pregnancy.

Some women experience dry mouth while pregnant. Frequent sips of water and chewing on sugarless gum or candy can help alleviate this symptom.

Diet can affect cavity formation, as well as the health of the developing baby. It is very important that a mother eat nutritious foods while pregnant and avoid high sugar or empty calorie foods. Nutritional guidance from an obstetrician is recommended.

After your baby is born, you will want him/her to start early with good oral health habits. To avoid the risk of baby bottle tooth decay, never put your baby to bed with milk, formula, juice or any other sugary liquid.

Researchers have recently found that a mother can pass on germs that cause tooth decay to her baby. Therefore, it is very important to brush and floss your baby’s teeth and to have the baby’s teeth examined by the dentist between 12 and 18 months of age. It is just as important for a woman to keep her teeth and gums very clean and healthy, so that she does not pass germs to the baby.

Oral Contraceptives. Because the birth control pill mimics the effects of pregnancy, women may experience the gum tissue changes previously discussed. In addition to these changes, women on birth control pills may be more prone to healing problems after tooth extraction. This can lead to what is known as a “dry socket,” a painful condition that can increase the likelihood of bone inflammation during the healing process. To help avoid this condition, schedule the extraction appointment during the non-estrogen “sugar pill” days (days 23-28) of the pill cycle.

Menopause. Menopause, a normal event in a woman’s life, also can bring about certain oral changes. The most common are pain, a burning sensation in the oral tissue, changes in taste and dry mouth.

Post Menopause. After menopause, there is an increased risk of developing osteoporosis (a condition of reduced bone mass and strength), which may increase the chance for tooth loss. Hormone replacement therapy may prevent this type of tooth loss. It is best to consult with your physician about the benefits and risks of hormone replacement therapy.

How can women help avoid oral conditions associated with hormone changes/fluctuations?

• Most importantly, maintain good daily oral care by brushing twice daily with toothpaste containing fluoride and by flossing once daily.
• Have your teeth professionally cleaned by your dentist or dental hygienist every six months (or more frequently if recommended by your dentist).
• Discuss with your dentist or dental hygienist any questions you may have as a woman about your oral health care. Together, you can outline a treatment plan specific to your needs.

Other Helpful Tips

• Pregnant women still need routine checkups. Always tell your dentist and his/her staff if you are pregnant.
• Always tell the dentist and his/her staff about any and all medications you are taking. Sometimes women feel uncomfortable telling a dentist about taking birth control pills. However, it is important for your dentist to know this information, especially when prescribing antibiotics. (It is possible to have an interaction between birth control pills and antibiotics that causes the birth control pill to be less effective).
• Eat a well balanced diet. Doing so in all phases of a woman’s life is important. However, certain vitamins and nutrients may be especially beneficial for oral health. Folate, B vitamins, protein, calcium and vitamin C help to maintain the support system around the teeth.

Remember, with good oral care, regular dental visits and good nutrition, a woman can keep her teeth for a lifetime.

For more information, contact

Illinois Department of Public Health, Division of Oral Health
535 W. Jefferson St., Springfield, IL 62761
217-785-4899, TTY (hearing impaired use only) 800-547-0466

NOTE: This fact sheet was derived from one previously published by the Arizona Department of Health Services.