Bleeding Gums: What It Means and When to See Your Dentist
Question: I’m taking an oral contraceptive, which I know can affect gum health. Is there extra stuff I should be doing to ensure I have healthy gums while taking this medication? Answer: This is a great question and I love that you’re thinking about prevention here. You’re right that oral contraceptives can affect gum health, but the good news is, yes, there are things you can do to protect the health of your gums. How Do Oral Contraceptives Affect Gum Health?
With an oral contraceptive, your body thinks it is pregnant, so these hormonal changes could be affecting your gum health.
It’s a known fact in dentistry that a pregnant or breastfeeding woman has gums that become inflamed and bleed a little upon provocation (which means, poked, brushed, or flossed, NOT cut or nicked as can be common misconception).
The impact might also depend on the type of birth control you’re taking.
Birth control pills can increase a woman’s inflammatory response, similar to what is seen in pregnancy, causing gums to be redder and swollen and to bleed more readily. During different stages of life, like pregnancy or menopause, hormonal changes can affect your gum health, as the hormonal changes can cause inflammation of the gum tissue.
That said, most of the research conducted was done back in the days when oral contraceptives had much higher hormone levels than the oral contraceptives we have today, so it’s possible that gum inflammation caused by birth control is a thing of the past.
A recent clinical study which examined the effects of birth control medications in young women found these hormonal agents had no effect on gum tissues.
As far as their effect on saliva, the reviews are mixed — some studies have shown an increase and some have shown a decrease in salivary flow.
Women taking birth control may also experience a higher chance of getting dry socket following extraction of wisdom teeth.
So, it pays to experiment with different oral contraceptives until you get it right. Don’t accept long term gum inflammation — you just don’t have to.
So, if you’re on birth control, you might have a lot of the same symptoms of gum disease, but you might not.
What I recommend for my patients is this:
How to Protect Your Gum Health While On Birth Control
Get a baseline reading. Make sure you get a baseline reading of the health of your gums before you go on birth control, as well as after, so you can compare the two states. This will allow you to truly assess how much your oral contraceptive impacts your gum health. Find out — is the impact severe or mild? Each type of oral contraceptive has different levels of hormones, so if the impact on your gum health is severe, you could try experimenting with a different one. What if you get gum disease while you’re on birth control? Without a baseline, you won’t know how much of a factor your birth control is.
Review your oral hygiene habits. When was the last time your hygienist showed you how to brush and floss? Most of us brush way too hard and don’t floss properly because we forget the C-shape motion. Make sure your flossing and brushing technique are stellar — if it was critical before, it will be extra critical for you now while you’re on birth control to prevent permanent damage to your gums.
Check your diet. A low-inflammation diet rich in alkaline, healthy foods will keep your gums healthy — giving you a different baseline to begin with. A better baseline for your gum health, even though you’re taking a hit with the contraceptive, will keep you healthier than you would have been.
Keep checking your pocket readings. Pocket readings are a great indicator of gum health — make sure to keep track of them in general, but especially while on birth control. Don’t stay on an oral contraceptive that severely impacts your gum health for very long. Morphological changes to the gums can have a permanent effect on your gum health, causing scar tissue buildup on the gums and irreversibly affecting the elasticity of the gums.
Have regular teeth cleanings. As with other hormone-related gingivitis, good home oral hygiene combined with professional cleanings should help manage symptoms.
The Key Takeaways
1. Pick an oral contraceptive that works for you, of course, but you want one that makes the least impact on your gum health.
2. It doesn’t take long for damage to the gums to become irreversible.
3. If you’re healthy to begin with and work to maintain that health while on birth control, you’ll be able to protect your gums. If you’re not healthy and you have gum disease while you take birth control, then things can really begin to get complicated health-wise in the mouth.
Thanks for asking this great question. Thinking this way means you’re thinking preventively before problems arise, and prevention is the best medicine in dentistry, medicine, and in life!
Mark Burhenne DDS
Learned something new today. I quit the pill about a year ago and I have never felt better. I never knew the pill could damage a woman’s gum as well. When it comes to oral health woman have a lot to take into consideration.