Women's publications often stress the importance of looking and feeling good, and beginning at an early age through adulthood women strive to live up to this image. Consequently, they may overlook the first feature noticed by others, the smile.

Throughout all stages of life, women should take extra care of their oral health. That's because their hormonal fluctuations can affect many tissues, including gum tissue.

A study in the Journal of Periodontology reports that at least 23 percent of women ages 30 to 54 have periodontitis. This is an infectious disease resulting in inflammation within the supporting tissues of the teeth and progressive attachment and bone loss. Eventually teeth can become loose and may have to be removed.

Periodontitis can be a "silent" disease and until it's in an advanced stage, many women don't know they have it.

The good news is there are steps you can take to protect your oral health through all stages of life. Regular professional cleanings, good at-home oral and periodontal evaluations can help you keep your teeth for a lifetime.

PUBERTY

Steroid hormone levels increase during puberty causing increased blood circulation to the gums. This could cause an increase in the gum's sensitivity to irritations, including food particles and plaque. These symptoms lessen as a young woman progresses through puberty.

While symptoms cannot always be avoided, proper at-home oral hygiene is the best means of prevention, including regular brushing and flossing and visits to your dental professional. In some cases, the dental professional may recommend periodontal therapy to prevent damage to the tissues and bone surrounding the teeth.

MENSTRUATION

Some women may experience menstruation gingivitis. During this condition, women may experience bleeding, bright red and/or swollen gums, and sores on the inside of the cheeks. Menstruation gingivitis typically occurs right before a woman's period and clears up once her period has started.

PREGNANCY

Pregnancy gingivitis may cause swelling, bleeding, redness or tenderness to the gum tissue. It may begin in the second or third month and increase in severity until the end of the pregnancy. It usually goes away after the eighth month of pregnancy, but in some women it may increase significantly. If this happens, the periodontist should be consulted. During pregnancy some women may also experience benign, painless gum tissue overgrowths sometimes called pregnancy tumors. If the overgrowth persists, it may require removal by a periodontist.

Women using oral contraceptives may experience the same oral effects of pregnant women.

MENOPAUSE

Women who are menopausal or post-menopausal may experience changes in their mouths, including dryness, pain and burning sensations, altered taste and gum recession. These changes are attributed to hormonal reduction, and can leave you prone to periodontal diseases. Talk to your periodontist about any oral changes, so that you can work together to develop a treatment plan that may relieve these symptoms.

Creating generations of happy, healthy smiles

A daughter will often inherit her mother's physical attributes such as eye color, cheekbones or smile. Did you know that a daughter is also susceptible to inheriting periodontal disease? Recent research provides further evidence that a person's genes play a major role in the onset and severity of periodontal disease. You can be tested for genetic links to periodontal disease with a simple swab of saliva from the inside of the cheek. Identification of people at high risk for periodontal disease, before they even display symptoms, may provide new avenues for treatment.

Typically, periodontists recommend that patients with good periodontal health have their teeth cleaned every six months. For the majority of the population, this routine, plus good personal oral hygiene including daily brushing and flossing, appear to be sufficient in maintaining healthy gums. If you are genetically susceptible to periodontal diseases, closer and more intensive preventive measures may be required to maintain the same level of oral health.

AAP Patient Page, April/June 2003, Vol. 4, No. 2;