context: Women may be more susceptible to oral health problems because of the unique hormonal changes they experience. Hormones affect not only the blood supply to the gum tissue but also the body's response to the toxins (poisons) that result from plaque buildup. As a result of these changes, women are more prone to the development of periodontal disease at certain stages of their lives, as well as to other oral health problems. There are five situations in a women's life during which hormone fluctuations make them more susceptible to oral health problems â during puberty, at certain points in the monthly menstrual cycle, when using birth control pills, during pregnancy, and at menopause. Puberty The surge in production of the female hormones estrogen and progesterone that occurs during puberty can increase the blood flow to the gums and change the way gum tissue reacts to irritants in plaque, causing the gum tissue to become red, tender, swollen, and more likely to bleed during brushing and flossing. The monthly menstrual cycle Due to the hormonal changes (particularly the increase in progesterone) that occur during the menstrual cycle, some women experience oral changes that can include bright red swollen gums, swollen salivary glands, development of canker sores, or bleeding gums. Menstruation gingivitis usually occurs a day or two before the start of the period and clears up shortly after the period has started. Use of birth control pills Women who take certain birth control pills that contain progesterone, which increases the level of that hormone in the body, may experience inflamed gum tissues due to the body's exaggerated reaction to the toxins produced from plaque. Tell your dentist if you are taking an oral contraceptive. Pregnancy Hormone levels change considerably during pregnancy. An increased level of progesterone, in particular, can cause gum disease any time during the second to eighth month of pregnancy â a condition called pregnancy gingivitis. Your dentist may recommend more frequent professional cleanings during your second or early third trimester to help reduce the chance of developing gingivitis. Tell your dentist if you are pregnant. Menopause Numerous oral changes can occur as a consequence of advanced age, the medications taken to combat diseases, and hormonal changes due to menopause. These oral changes can include altered taste, burning sensations in the mouth, greater sensitivity to hot and cold foods and beverages, and decreased salivary flow that can result in dry mouth. Dry mouth, in turn, can result in the development of tooth decay and gum disease, because saliva is not available to moisten and cleanse the mouth by neutralizing acids produced by plaque. Dry mouth can also result from many prescription and over-the-counter medications that are commonly prescribed to older adults. The decline in estrogen that occurs with menopause also puts women at greater risk for loss of bone density. Loss of bone, specifically in the jaw, can lead to tooth loss. Receding gums can be a sign of bone loss in the jawbone. Receding gums also expose more of the tooth surface to potential tooth decay. Some tips for preventing oral health problems like gum disease and tooth decay include: Brush your teeth at least twice a day with a fluoride-containing toothpaste. Floss and rinse with an antiseptic mouthwash at least once a day. Visit your dentist twice a year for a professional oral examination and cleaning. Eat a well balanced diet. Avoid sugary or starchy snacks. Ask your dentist if he or she thinks you should use an antimicrobial mouth rinse. If you have dry mouth, ask your dentist about treatments for this condition, such as artificial saliva. Biotene is one such product and is available over the counter.