What Harmony Is There Between Oral Health And “women’s Health”?

Systemic health has ramifications for oral health – the state of wellbeing of the structures coming together to form the oral cavity and its immediate extra-oral (maxillofacial) structures. Some of these structures include but not limited to the lips, tongue, teeth, gum, palate, uvula, and jaws, grossly and histologically or even genetically. On the back of our genetic uniqueness that may make us respond differently to diverse disease conditions, there are variations in the health reality of people with respect to race, age, physical environmental contexts, and sex, among others. We could therefore talk about women’s health.

The concept of women’s health emerges when we think of the wellbeing of sex-based biology and function with special reference to women (persons with genotype of XX-referring to the 23rd pair of chromosomes). Biomedically, women’s health encompasses the physical (biomedical), mental, and socio-economic wellbeing of women in relation to their sexual, reproductive, and psychological make-up.

Biomedically, the systemic health of women has implications for oral health, thereby bridging the two and providing a case for the need to think of one in terms of the other. The consequence of women’s health for oral health spans especially the influence of menstruation and pregnancy. Hormonal fluctuations are critical in this regard.

There are several phases in the menstrual cycle. The two phases of concern here are the follicular and luteal phases. The follicular phase follows the menstrual phase. However, the early part of the follicular phases overlaps with the menstrual phase. There is a surge in the hormone estrogen in the follicular phase.

It is good to insert here that receptors on which estrogen binds to have an effect are expressed on the periodontal ligaments (supporting structure of the teeth). This is important in maintaining the health of the periodontal ligaments. In conditions in which there is a reduction in estrogen, as is seen in menopausal women, can lead to periodontal diseases. Fluctuations in estrogen also influences the density of the jaw bones, including the alveolar bone, the immediate bone in which the roots of the teeth are embedded.

Grossly, increase in estrogen during this phase increases blood flow to the gum and other soft tissues of the oral cavity, predisposing the gum of women to easy bleeding. The same is seen with the surge in progesterone during the luteal phase prior to fertilization of released egg or otherwise. Estrogen also mediates the body’s response to toxins. The importance of this is seen in the presence of plaque bacteria. Fluctuations in estrogen influences how the body responds to these bacteria and their influence in inflammation of the gum and dental caries, in the long term.

Estrogen has as an anti-inflammatory effect and hence reduces inflammation of the gum. This implies that situations that impinge on the level of estrogen, as is seen menopausal women, can lead to an increase gingivitis. In menopause, there is reduction in salivation leading to dry mouth with its accompanying dental caries since the buffering action of saliva on acidic substances produced from bacterial action is compromised leading to cavitation of the hard tissues of the teeth.

Hormonal fluctuations continue in pregnancy. This leads to gum swellings, pain in the gum, reddening of gum and easy bleeding of the gum. This condition is often described as pregnancy gingivitis. The larger portion of pregnant women suffer from this gingivitis generating anxiety in many of them.

It is important that girls and women pay particular attention to their oral health in the context of the foregoing discussion. They must be aware of the implication of their sexual and reproductive nature on their oral health to allay their fear. They must be intentional about oral hygiene measures that will control plaque bacteria adequately. This includes, primarily, brushing twice daily using a soft toothbrush and a toothpaste with an optimum fluoride content; flossing after brushing; routinely visiting the dentist once every six months for check ups.

Furthermore, before a woman gets pregnant, of course for intentional pregnancy, it is important that she visits the dentists or oral surgeon for a comprehensive check up. Where there is a need for invasive treatment procedures to be done, this can be carried out prior to the woman getting pregnant. This holds same for elective procedures as well. These can be scheduled before pregnancy or after childbirth. This approach will ensure protection for both mother and child in this regard.

During the first trimester of pregnancy, the period of organogenesis, limited dental and oral surgery procedures can be done unless they are of critical importance. This adds to the reasons why women must be intentional about their oral health before, during and after pregnancy.

Overall, considering the number of women who are faced with oral conditions owing to their biology and body functions, it is important to prepare for this at every level, from national policies to family and individual efforts, to address this pervading situation.