Beneath The Smile of a Woman


By Dr. Valerie Pereira, Consultant Periodontist

You know her. The strong and kind woman who moves forward with grace and empathy.

She is your mother, sister, wife, grandmother, friend or daughter. Maybe you are here, reading this article. She always brings a smile to your face.

And her smile lights up your world.

But what goes on behind a woman’s smile in her mouth?

Women’s mouths are different from men’s due to estrogen receptors in the soft tissues of the mouth.As a result, they suffer from different diseases, especially with hormonal fluctuations.

In fact, with poor oral health, women are more prone to cardiovascular diseases, respiratory diseases, diabetes and more. By raising awareness about different conditions, we can help women take care of their oral health and influence better health outcomes -not just for themselves, but also for their families.

Here is a list of changes to watch and monitor from childhood to old age.


Surging levels of the hormones, estrogen and progesterone during puberty, modulate the oral environment, predisposing female teens to an increased risk of gingivitis, especially if oral hygiene is not maintained. This leads to an increased presence of microorganisms.

The gums usually appear bright red and may bleed. This is easily corrected by scaling and improved oral hygiene.

Also, deficiencies like Iron deficiency, anaemia, and Vitamin B12 deficiency may be observed in the mouth.According to studies, approximately 50% of adolescents ages 12 to 15 years suffer from tooth caries. So, a visit to the dentist by the ages of 9-15 years is a must, also to check for any crowding or malpositioning of teeth. In addition, Herpes labialis, aphthous ulcers and angular cheilitis may be seen.

B. Oral Contraceptives

Women consuming hormonal contraceptives are vulnerable to oral health issues. Contraceptives mimic a state of pregnancy, and a high level of progesterone and estrogen influence an increase in bacterial colonization leading to swollen and/or bleeding gums.

Women must inform their dentist about contraceptive use, particularly if they need to have a tooth extracted because they are likely to develop a painful condition after extraction called dry socket. For these women, teeth may be extracted on days that the woman is not on the pill.


The health of a pregnant woman and her baby are closely linked and affected by the mother’s oral health. 

75% of women have swollen or bleeding gums during their pregnancy called Pregnancy Gingivitis.

Pregnant women should visit the dentist and have a scaling done.Women generally are apprehensive to have the treatment done during their pregnancy, but it is safe to do so in their second trimester. A delay in treatment may result in a risk to the woman and the foetus. Preterm birth, low birth weight, and poor glucose control have been associated with periodontal disease during pregnancy. In addition, periodontal disease during pregnancy is linked with pre-eclampsia.

Also, erosion of teeth can take place because of frequent vomiting in the first trimester.

D. Postpartum

Postpartum, the woman must follow up on her dental care. This is because transmission of Streptococcus mutans, the bacteria that causes dental caries, takes place from mother to child. So, a mother who has decay passes this on to her newborn even before the baby’s teeth have erupted! 

Also, sharing food and cleaning the pacifier with the mother’s saliva should be avoided to prevent childhood caries.

E. Menopause

The woman’s mouth contains estrogen receptors. Menopause results in a decrease in the amount of systemic estrogen causing oral pain and discomfort, burning, mucosal atrophy, and osteoporosis.

This causes bone loss in the jaw too and subsequently tooth loss. Implants and other tooth replacement options must be made available to the woman.

Counselling for women who have lost all their teeth and need dentures is a must.

F. Miscellaneous

Many other conditions can be seen in a woman’s mouth like white lesions, pemphigus or other mucocutaneous lesions.

The salivary flow can also decrease due to stones in the salivary ducts or other causes leading to dryness.

Diet and nutrition are important factors to be considered especially for women(Iron, Vitamin C, Calcium, Omega-3 fatty acids and Vitamin D).

Many young girls suffer from eating disorders like Bulimia and Anorexia Nervosa and these show signs in the mouth.

It’s important that women monitor changes like pain, bleeding, dryness, oral hygiene and ulcers in their mouths.

This should ensure that women have “smiles for a lifetime ” which in turn shall light up the world.

About the Author:

Dr. Valerie Anithra Pereira is a consultant dentist who specialises in Periodontics (gums). She has completed her BDS from AJ Institute of Dental Sciences, Mangalore. She then practiced at Narayana Hrudayalaya in Bangalore before going on to do her Masters in Periodontics and Implantology (MDS) at Rajiv Gandhi University of Health Sciences in Coorg. She has worked as an Assistant Professor in Periodontology at Bhopal University and Maharashtra University of Health Sciences, Nashik She is available for consultation in Panjim, Goa.

She can be contacted on: 8208007184.