Bacteria and toxins in dental plaque, a sticky colorless film that constantly forms on the teeth, causes gum disease, also known as periodontal disease. Gum disease affects the gums as well as the supporting structures of the teeth. Gingivitis, the earliest stage of gum disease, usually causes the gums to be tender, swell, turn red and bleed easily. The bleeding and swelling sometimes are visible only to your dentist. You put yourself at risk for gum disease if you are not diligent in your home regimen of oral care—brushing and flossing—plus regular visits to your dentist. Your gums can become sensitive, sometimes reacting strongly to the hormonal fluctuations that occur throughout your lifetime. And these same fluctuations may make you more susceptible to gum disease or make existing gum disease worse.
    If left untreated, gum disease can progress to a more serious stage that damages or destroys the bone and tissue surrounding the teeth. With continued neglect to seek treatment, your teeth will eventually loosen and may be lost.

As a woman, your sex hormones predispose you to unique oral health needs. You need to take extra care of yourself at times when your body is going through hormonal changes, such as at puberty or menopause, or during menstruation or pregnancy.
    Hormonal surges and ebbs during these times can affect many of the tissues in your body, including your gums. Therefore, your oral health needs change, too. Diet, exercise and regular visits to your physician are important to maintain good health. Daily brushing and flossing and regular visits to your dentist are important, too.

If you are going through puberty, your female sex hormones—progesterone and possibly estrogen—levels increase. As a consequence, blood circulation to the gums is increased, possibly accompanied by increased gum sensitivity. Then, food particles, bacterial plaque and tartar cause greater susceptibility of the gums to react to these local irritants and swell.
    A dental professional must remove these irritants to protect the bone and tissue surrounding the teeth from damage. Afterward, you will need to be diligent in your home regimen of oral care to prevent further swelling.
    As puberty progresses, your gums will have less tendency to swell. Brushing and flossing along with regular professional dental care are vital at this stage in your young womanhood.

If you are menstruating, gingivitis accompanied by accumulation of plaque can be more prevalent because of the surge of progesterone before your period, or menses, begins. Your mouth might have sores or bleeding for three or four days before your period starts. Although it is rare, you might have gingivitis, characterized by bright red swollen gums between the teeth and sores on the tongue and the tissue inside the cheeks, preceding your period, then clearing up once the period starts. During these hormonal fluctuations, it is especially necessary to maintain oral health.

The old wives' tale, “A tooth lost for every child,” seems far-fetched, but it actually has a loose basis in fact. If you are pregnant, changes in your hormone levels affect your teeth and gums just as they do other tissues in your body.
    Most commonly, gingivitis increases beginning in the second or third month, becomes more severe through the eighth month, then begins to diminish in the ninth month. In this condition, called “pregnancy gingivitis,” increased progesterone secretion causes gum tissue to increasingly swell, bleed and redden in response to a very small amount of plaque.
    If your gums are healthy before pregnancy, you are less likely to have problems. Pregnancy gingivitis usually does not affect healthy gum tissue, but just previously inflamed regions. If left untreated, pregnancy gingivitis can damage the gums and bone supporting your teeth. This damage then leads to loss of gum tissue and bone.
    To reduce gingival problems during pregnancy, you need to have a professional cleaning to remove irritants. You also need to be diligent in your daily, home regimen of oral care. During pregnancy, more than ever, you need to have regular dental examinations. Don't skip a scheduled dental checkup. During your second trimester or early third trimester, more frequent professional cleanings may be beneficial. Remember, if you have tender, bleeding or swollen gums during your pregnancy, notify your dentist as soon as possible.
    Occasionally, a large swelling of gum tissue will form, marked with many deep-red pinpoints. This “pregnancy tumor” is an extreme inflammatory response to local irritants such as food particles, plaque or tartar. This growth may occur any time during pregnancy, but it most often appears during the third month of pregnancy. Although it is usually painless, the tumor can become painful if it interferes with your bite or if food debris collects beneath it.
    A pregnancy tumor is definitely not a cancer. It may be treated by professional removal of all local irritants, followed by a diligent home regimen of oral care. Be sure to discuss further treatment or removal with your dentist and your obstetrician. If you have any gum problems during your pregnancy, you must have your entire mouth examined and your periodontal health evaluated after your delivery. Your dentist can determine necessary treatment at that visit.

Use of birth control pills may make you susceptible to the same oral health conditions that affect pregnant women. Many medications, such as antibiotics, can lessen the effectiveness of oral contraceptives. Therefore, it is important that you inform your dentist or physician that you are taking birth control pills before either one prescribes any medication for you.

If you are menopausal, any oral problem that you have probably is not related to the hormonal changes you are undergoing. If you take estrogen supplements, they should have little effect, if any, on your oral health. If you have the rare condition called “menopausal gingivostomatitis”, your gums will be dry and shiny, bleed easily and appear abnormally pale to deep red. Your other symptoms might include a dry, burning sensation in your mouth, abnormal taste sensations—especially salty, peppery or sour—and extreme sensitivity to hot or cold foods or drinks. Also, you may find it difficult to remove any partial bridges or dentures.
    As you make the transition through these various phases of your life cycle, always remember the importance of oral health to your overall health and well-being. Then, greet each new day and each new change with a bright, healthy smile.