One of the first things people tend to notice about you is your smile.
A smile reflects the character and confidence of the person.
Smiling not only improves your overall appearance, but also causes the release of endorphins, which can improve your mood and make you feel more assured and confident to face the day.
However, that beautiful smile will not be there if you do not take good care of your oral health.
No matter how much make-up you use or how many times you bleach your teeth to be as white as snow, nothing can hide the expression of an agonising toothache or an uncontrolled bleeding gum!
Poor oral health has the potential to negatively impact your career prospects, social connections and general health.
It can also worsen the condition of those with chronic diseases like diabetes, lung disease or heart disease, through infections and decreased immunity.
During one’s period
The hormonal changes that women undergo during the menstrual cycle can have an effect on oral health.
For example, the increase of the hormone progesterone during ovulation and in the days preceding menstruation can cause swelling, redness and bleeding of the gums.
Similar symptoms may result from taking birth control pills and devices that raise the levels of progesterone and oestrogen.
Such hormonal changes can also complicate certain dental procedures and subsequent healing.
Female teens and young adults can also be prone to canker sores during their periods.
These are small, shallow, non-contagious lesions that develop on the soft tissues in the mouth, at the base of the gums, or the inside of the cheeks or lips.
Medically known as aphthous ulcers, they are triggered by stress and acidic foods, and can make eating and talking uncomfortable and painful.
Although they will resolve on their own, do check with your dentist if they occur frequently, especially outside your period.
Your dentist may want to check your vitamin B12, zinc, folic acid and iron levels, or test for food allergies.
He or she can advise you on diet, how to keep your mouth clean, and how to prevent trauma to the sores when brushing your teeth, as well as prescribe a suitable mouthwash.
When one’s pregnant
In its 2022 Global Oral Health Status Report, the World Health Organization (WHO) noted that almost half (45% or 3.5 billion) of the world population suffers from oral diseases.
The most common one is untreated dental caries, decaying into cavities, which can negatively impact the individual’s quality of life.
Numerous studies have shown that untreated dental caries or tooth decay in pregnant ladies increases the risk for dental caries in their child through the vertical transmission of bacteria from mother to baby.
The first kiss a newborn receives is the start for such transmission or transfer of mouth bacteria.
So don’t let just anyone give baby that first kiss!
Studies as early as 1931 have identified that hormonal changes associated with pregnancy can result in swollen or bleeding gums, inflammation of the gingiva, and even loosen teeth.
Pregnancy tumours – also known as granuloma gravidarum and pyogenic granuloma – that occur in the mouth can also result due to these hormonal changes.
If small, these benign growths will shrink a few weeks after delivery, but some may need a dental intervention to remove the tumour.
Excessive acid production due to morning sickness, heartburn, vomiting and nausea can contribute to the erosion of the pearly white outer tooth layer, i.e. the enamel.
This can result in gnawing pain and sensitivity to the touch of anything cold entering the mouth.
Research has also shown an association between maternal periodontal disease during pregnancy and adverse birth outcomes, such as preterm birth, low birth weight, stillbirth, miscarriage, intrauterine growth restriction, and pre-eclampsia with possible delivery complications.
Sadly, despite the availability and accessibility of integrated government dental and antenatal clinic services throughout Malaysia, less than 30% of pregnant mothers utilise oral care services.
A study reported that common excuses given by most pregnant women included perceptions of not having any oral health problems, long waiting time at the clinic, and no immediate treatment given by the dentist.
It’s important to note that regular dental care throughout pregnancy is safe, improves maternal health, and can reduce the likelihood of some adverse pregnancy outcomes.
As one ages
Women’s oral health is also affected by the hormonal changes during menopause.
After menopause, lower oestrogen levels increase the risk of osteoporosis.
This is more obviously seen in relatively porous or wobbly teeth, which can result in severe gum disease and tooth loss.
Those with loss of teeth and not wearing dentures may not be able to chew well, thus aggravating their digestive system.
Systemic autoimmune conditions affecting women as they grow older can also result in oral health complications.
The 2022 US National Institutes of Health report on women’s oral health found that one to four million people in the United States are affected by Sjögren’s disease.
This disorder of the immune system affects the moisture-secreting glands of the mouth and eyes, decreasing production of saliva and tears.
Women were reported to be nine times more likely to have the disease than men.
Data on this disease and its manifestations in the mouth is lacking in Malaysia though.
Other autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis and vasculitis, have been reported to have a 16:1 female to male ratio.
Also, as one ages, less saliva is produced by the salivary glands in the mouth.
This results in the mouth feeling dry – a condition termed xerostomia.
This is also occurs frequently among those with few teeth left, or those using prescription medications, harmful drugs, tobacco and e-cigarettes, as well as those undergoing cancer therapy.
Xerostomia can increase the risk of dental caries and infections to other body parts, as well as trigger sore gums and other oral diseases.
The mouth can generate embarrassing smells, and many also experience a continuous blunt soreness, pain or burning sensations.
Diseases affecting the jaw joints that hold your upper and lower jaws together, and surrounding muscles and ligaments, can occur as one ages.
These temporomandibular disorders (TMDs) can be caused by trauma, an improper bite or chewing system, or arthritis.
Common symptoms include jaw tenderness, headaches, earaches and facial pain.
These conditions are also associated with generalised joint pain, tinnitus (ringing in the ear), headaches, inflammation, visual disturbances, chronic fatigue and sleep disorders.
Women, unfortunately, are twice as likely to develop TMD as men.
With the increase in domestic violence and motor vehicle accidents in Malaysia, alongside an expected increase in falls among the increasing elderly population, perhaps it is time TMDs be given due attention by all.
Prevention first
Most oral diseases are preventable if you take heed of your dentist’s advice.
Unfortunately, many fail to go for the recommended biannual or annual dental check-up.
The mouth is the first port of entry into our body and has a direct link to all our other organs.
Failure to recognise the importance of your mouth health means failure to look after the other parts of your body!
Here are some simple tips to maintain good oral health:
A regular and timely annual check-up will avoid many “painful“ future treatment visits.
For small lesions identified early, your dentist can recommend less painful, less invasive procedures at less cost and less mental trauma.
A smelly mouth is the by-product of dead bacteria, dead tissue cells, leftover foods and excess mouth acids.
Keep your mouth clean by diligently brushing your teeth at least twice a day.
Also, don’t forget to floss between your teeth.
Find one comfortable technique that suits you best or ask your dentist for advice.
Leftover foods and bacteria tend to stick between the teeth, and these hidden spots are where cavities are likely to start before infecting the next tooth!
Rinsing your mouth with water after each meal will help get rid of stuck food and plaque.
You can also rinse with a fluoride mouthwash after brushing your teeth before going to bed.
All women, especially adults and the elderly, should habitually do mouth exercises to loosen muscular tension around their face and in the mouth.
Simply move your tongue from side to side, followed by tongue-rolling and lips pouting (as though you are whistling) at least five times a day.
Ask your dentist to teach you how to do a fortnightly or monthly one-to-three-minute self-mouth check.
This can help you detect unwanted lesions, ulcers or lumps (possible signs of mouth cancer), or tissue abnormalities, early and take action fast.
Late treatment can be deleterious as it may cause facial disfigurement, which can also affect your mental health.
Professor Dr Rahimah Abdul Kadir is a dental public health specialist, adjunct professor at Universiti Malaya and president of the Alliance for Cavity Free Future Malaysia Chapter. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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