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Common dental issues women face as they get older

Bad brushing habits, not seeing your dentist often and… hormones? Here's how these affect your oral health

By Balvinder Sandhu - 

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When we talk about looking after our health, do you think about oral health? We know the basic rules of oral health, like how we should brush our teeth twice a day (bonus points if you do this after every meal) and visit the dentist at least once a year. But did you know that being female puts us at a higher risk of oral health issues?

If you're wondering why this is the case, blame it on… (surprise, surprise!) hormones. We experience heightened hormone levels during our menstrual cycle, pregnancy and menopause, and this can raise the risk of dental issues.

“Hormonal changes during puberty, the monthly period cycles and pregnancy often bring about increased sensitivity to bacterial plaque accumulation, resulting in swollen and bleeding gums,” explained Dr Yang Jingrong, periodontics consultant at the department of restorative dentistry, National Dental Centre Singapore. “However, an important point to note is that, in a clean mouth, these hormonal changes do not cause these symptoms.”

Dr Yang explained that there has been no recent studies of dental disease amongst Singaporean adults – the last one was conducted in 1996. However, a 2017 study found that in Singapore, 31 per cent of residents above 60 years of age have no teeth at all. 

“This proportion is considerably higher compared to the 17 to 20 per cent reported in other developed countries. The higher prevalence of chronic diseases – including oral diseases – due to the ageing population will place increasing demands on Singapore’s healthcare system,” she said. 

So what's the best way to look after our oral health, to avoid issues in the future? The key is paying attention to the amount of plaque you have. Plaque is the film of bacteria that forms on your teeth and it accumulates on a daily basis. Aim to reduce the bacterial load in your mouth, through good oral hygiene, to prevent gum disease and tooth decay. 

Quick refresher: What's good oral hygiene?

  1. Thorough toothbrushing, especially at the gum line (junction between teeth and gums) with a soft bristled toothbrush
  2. Use of interdental aids (flossing, interdental brushes) to clean in between the teeth
  3. Tongue cleaning, either with a tongue scraper or a toothbrush

When we get older, menopause may affect oral health too. The hormonal changes cause dry mouth, changes to the taste of food, burning sensation in the mouth and greater teeth sensitivity to hot and cold food and drinks, said Dr Yang. Having a dry mouth puts you at a higher risk of tooth decay due to the lack of protection from saliva.

Sounds bleak, but the good news is, our oral health status is pretty much in our hands – to be more specific, it lies with our oral hygiene and lifestyle habits. Here's a look at the top dental issues among women in their 20s to 40s, and how to keep them at bay.

Top dental issues among women

Dental issue #1: Gingivitis

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What it is: A mild form of gum disease caused by plaque and tartar (hardened plaque) build-up. Gum disease is a chronic bacterial infection that affects the gums as well as the bone supporting the tooth.

Signs and symptoms: Your gums are red or swollen, and they bleed when you brush or floss your teeth. Your gums could be painful or tender, and you feel a vague discomfort or dull ache in both your gums and teeth. However, most people don't experience any pain even though they have gum disease.

How to prevent or lower risk: Brush your teeth at least twice a day and floss every day. Get a professional clean from your dentist twice a year. And don't smoke – smoking is a high risk factor for gum disease.

Treatment options: It can be reversed by good oral hygiene and dental scaling. If you leave gum disease untreated, you could lose your tooth/teeth.

Dr Yang says: “Ladies with gum disease may find that the symptoms are more severe during their periods and/or pregnancies as the hormonal changes will exacerbate and exaggerate the symptoms.”

Dental issue #2: Periodontitis

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What it is: If left untreated, gingivitis can develop into a chronic gum condition known as periodontitis, which is characterised by the irreversible loss of the supporting bone around teeth.
Signs and symptoms: Bleeding gums (either spontaneously or on brushing), gum swelling, pus, mobile teeth and mild discomfort on the gums.

How to prevent or lower risk: Once you're diagnosed with gum disease, get treated and do everything you can to keep it at bay.

Treatment options: Periodontal treatment such as scaling to remove tartar/calculus (hardened plaque) from above and below the gum line, and polishing to remove plaque from the root surface.

Dr Yang says: "Some women with untreated periodontitis face a higher risk of developing gestational diabetes. Besides causing high blood sugar that can affect the pregnancy and the baby’s health, persons with gestational diabetes also have a seven-fold increased risk of developing diabetes subsequently in life. In turn, untreated periodontitis can cause difficulties in achieving good control of blood sugar levels."

Dental issue #3: Erosion of teeth

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What it is: It is characterised as wearing of the teeth enamel, the outermost layer of the teeth. This exposes the underlying dentine (the tissue beneath your tooth enamel) that may result in teeth sensitivity.

Signs and symptoms: Sensitivity of teeth to hot, cold and sweet food and drinks, and yellowish discolouration of teeth brought about by dentine exposure.

How to prevent or lower risk: Follow a good diet and avoid foods and drinks that contain high levels of acid such as soft drinks (including the sugar-free options), fruit juices/cordials, vinegar and alcoholic drinks. Note that citrus fruits are also high in acid but you're better off eating the fruit than drinking its juice. As with other dental issues, you should also have good oral hygiene and visit your dentist regularly.

Treatment options: Your dentist will suggest treatments such as fillings, crowns or veneers.

Dr Yang says: “The causes of erosion include prolonged and excessive intake of acidic foods and drinks such as citrus fruits, fruit juices and ciders. It may also be due to gastric reflux disease or excessive regurgitation of gastric contents due to eating disorders and morning sickness, brought about by hormonal changes during pregnancy.”
Join this online forum to learn more
In conjunction with World Oral Health Day, the National Dental Centre is hosting an online forum “Healthy Smiles For a Lifetime” on March 19, 2022, Saturday, 10am to 12pm.

Held on Zoom, four experts from Paediatric, Orthodontic, Oral and Maxillofacial Surgery and Prosthodontic departments will cover topics such as wisdom tooth removal, teeth alignment and teeth replacement options. They will also share tips to take care of your oral health at every stage of life.

Register for the forum here.

For more info, head to https://www.ndcs.com.sg/healthy-smiles-for-a-lifetime.

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