During those times in a woman’s life where gum sensitivity may increase is due to hormonal shifts, such as those experienced during their Puberty, Menstruation, Pregnancy, and Menopause. There is increased production of hormones and these higher levels lead to greater irritations from plaque and food particles. During this period, the gums may bleed easily, be redder, tender, or swollen. These symptoms can flare up during the days leading up to one’s cycle but dissipate once the cycle begins. There is an exaggerated inflammatory response to the plaque. Strict oral hygiene maintenance is of prime importance for the patient because it is the dental plaque that leads to incidence and prevalence of disease while the level of hormone modifies the response.
Pubertal gingivitis
Puberty is a complex process of sexual maturation, and it is responsible for changes in physical appearance and behavior that are related to increased levels of the sex steroid hormone estradiol in females. Gingivitis is characterized by the hyperplastic reaction leading to gingival enlargement and onset of exuberant inflammation of the gingiva. It is associated with increased bleeding tendency, inflamed tissues become deep red and may be lobulated, with ballooning distortion of the interdental papillae. Bleeding may occur when patients chew or brush their teeth. Mostly seen t 12 -13 years of age. So, take care of your young Teens !
Pregnancy induced gingivitis and pregnancy tumour
Gum disease during pregnancy, called pregnancy gingivitis, places you at greater risk of having a premature birth, and consequently, a lower birth weight baby. This is not the time to skip scheduled professional cleanings and checkups. Pregnant women are more prone to inflammation and gingival bleeding. Sometimes during pregnancy, between the second and eighth months, large lumps (localized gingival enlargement resembling pyogenic granulomas) may appear as a reaction to local irritants. These lesions are known as pregnancy tumour. The pregnancy tumor bleeds easily and may range in color from purplish red to deep blue, although most commonly is red in color with small fibrin spot. Tooth mobility is also increased in pregnancy. These growths are generally painless and are not malignant/cancerous. They may require professional removal, but usually disappear on their own after pregnancy. Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk. There is also a higher incidence of pre-term low birth weight babies in women with periodontitis.
The artificial use of hormones in oral contraceptives or post-menopausal hormone replacement therapy can cause similar symptoms. These symptoms usually clear up as the amounts of hormones decrease, for example once menstruation begins or pregnancy ends.
Post menopausal gingivostomatitis
For women who are menopausal or older, changes in the gums may be noticeable. This arises because of fluctuating estrogen levels in the body. Estrogen can impact a variety of oral tissues, such as the gums, salivary glands, as well as the jawbone. So, you might notice a reduction in saliva production leading to dry mouth, pain in the gums or a burning in your gums and tongue, tooth loss, and altered taste buds–a change to sour or salty preferences, or not being able to taste sweet things as easily. Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of “dry mouth.”
Management
Firstly all local irritants should be removed, and meticulous plaque control be maintained. Patients should be educated regarding the profound effects of the sex hormone on oral tissues as well as the consistent need for home and office removal of local irritants. Milder form of gingivitis cases responds well to scaling and root planing. Severe cases, where enlargement occurs, requires surgical excision. For menopausal gingivitis hormone, replacement therapy can be included.