Ask most dental professionals whether they factor hormonal status into their clinical assessment of a female patient, and the honest answer is often: not as routinely as perhaps they should. Yet the evidence is there: oestrogen and progesterone exert a significant influence on oral tissues throughout a woman’s life, from puberty through pregnancy to menopause.[i] Gingival epithelial cells carry oestrogen receptors and respond to fluctuating hormone levels, meaning that the oral cavity is, in a sense, a real target of the hormonal effect. Understanding that relationship can make a meaningful difference to how dental professionals interpret symptoms, manage expectations, and advise their patients.
Menstruation and oral health
For many women, cyclical changes in oral health are a lived experience that rarely gets named in a dental consultation. Studies suggest that women may experience variations in gum health across their menstrual cycle: increased gingival sensitivity, a tendency toward bleeding, and in some cases canker sores or heightened susceptibility to oral bacteria during specific phases. Research has also shown that hormonal fluctuations during menstruation can increase tooth mobility, likely due to physicochemical changes in the periodontium.[ii]
These are perhaps not as significant clinically as other presentations, but they are still meaningful, particularly when it comes to patients presenting with symptoms that don’t correctly correlate with plaque levels and are resistant to standard hygiene advice. If a patient’s gums bleed at a certain time in her cycle, that does not necessarily mean she is non-compliant; she may simply be experiencing a hormonal response that her clinician hasn’t yet considered as a factor.
Including menstrual cycle stages as part of a female patient’s oral health history, alongside contraceptive use, can add a layer of previously underutilised context that changes the interpretation of what may have been a puzzling set of symptoms.
Pregnancy: the big hormonal challenge
Pregnancy will likely cause the most consequential hormonal shift in a woman’s oral health journey. Elevated oestrogen and progesterone levels exacerbate gingival inflammation significantly, and the scale of the problem is larger than many practitioners appreciate. Studies indicate that up to 75% of pregnant women suffer from gum inflammation, particularly in the second and third trimesters.[iii] Pregnancy gingivitis, characterised by swollen, tender gums that bleed easily, is the most common manifestation, but it can go beyond that. In some cases, a localised overgrowth known as a pyogenic granuloma, or pregnancy tumour, develops on the gingival margin, typically painless but alarming to patients who have not been warned it can occur.[iv]
Acute dental pain in pregnancy introduces an additional layer of complexity that GDPs encounter regularly. Pregnant patients are frequently reluctant to take systemic analgesics, particularly in the first trimester, out of concern for foetal exposure. This is understandable, but it can result in unnecessary suffering and delayed engagement with dental care. Topical benzocaine is an example of a local anaesthetic that, when applied to the site of the pain, can be a practical option for short-term pain relief, generally considered low-risk when used in small, occasional doses during pregnancy.[v] However, it is of course always important for the patient to consult with their GP before decisions like this during pregnancy.
Menopause and the overlooked oral factor
The menopausal transition might be well understood in terms of its overall effects, but its oral implications receive considerably less attention – in both medical and dental settings. The decline in oestrogen levels that characterises menopause leads to a range of oral changes that can significantly affect quality of life and, if unrecognised, lead to some form of clinical mismanagement.
Xerostomia – dry mouth – is among the most common oral symptoms for menopause, and its consequences can create real discomfort. Reduced salivary flow increases susceptibility significantly to dental caries, and compromises the oral mucosa’s ability to resist acid and infection.[vi] Burning mouth syndrome, a condition characterised by chronic oral burning or pain without a visible change in the mucosa, has a well-established association with the menopause transition, and is considered disproportionately underdiagnosed.[vii]
Putting this into practice
The common thread across these life stages is that hormonal context can change the overall diagnosis, and that integrating discussions like these can give the kind of information that will only improve care. With many of these arising issues directly causing discomfort or pain in women, it’s important to consider more than just the visible presentation of symptoms, and keep in mind that dental pain can have plenty of underdiagnosed sources.
When it comes to acute dental pain management, including for patients experiencing hormone-related dental discomfort, Orajel offers practical options that address it quickly.[viii] Available in standard and extra strength formulations, which contain 10%[ix] and 20%[x] benzocaine respectively, Orajel gets to work in just two minutes, providing localised relief while patients await treatment.viii
The dental consultation is one of the few healthcare interactions that spans a woman’s entire adult life. Used well, this can be a great opportunity to recognise and respond to hormonal fluctuations throughout a lifetime.
For essential information, and to see the full range of Orajel products, please visit https://www.orajelhcp.co.uk/
Author: Sumera Bashir, Church and Dwight UK Medical Affairs & Scientific Engagement Lead
[i] Lopes Cardoso I, Fryde M, Guimarães MI, Leal F. Impact of female hormonal changes throughout life on oral health: A scoping review. J Dent Sci. 2026;21(1):31-48. doi:10.1016/j.jds.2025.09.016
[ii] Mishra P, Marawar PP, Byakod G, Mohitey J, Mishra SS. A study to evaluate mobility of teeth during menstrual cycle using Periotest. J Indian Soc Periodontol. 2013;17(2):219-224. doi:10.4103/0972-124X.113078
[iii] Varsha A, Garg A, Thakur R. Effects of Pregnancy on Oral Health: A Narrative Review. Cureus. 2025;17(10):e94929. Published 2025 Oct 19. doi:10.7759/cureus.94929
[iv] Meshram M, Durge K, Shirbhate U. An Overview of Oral Pyogenic Granuloma and Its Management: A Case Report. Cureus. 2023;15(11):e48305. Published 2023 Nov 5. doi:10.7759/cureus.48305
[v] MotherToBaby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Benzocaine. 2025 Apr. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582601/
[vi] ADA. Xerostomia (Dry Mouth). www.ada.org. Published April 24, 2023. https://www.ada.org/resources/ada-library/oral-health-topics/xerostomia
[vii] Vaidya R. Burning mouth syndrome at menopause: Elusive etiology. J Midlife Health. 2012;3(1):3-4. doi:10.4103/0976-7800.98809
[viii] Hersh, EV, et al. An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothache. J Am Dent Assoc. 2013;144(5):517–526.
[ix] Orajel Dental Gel. Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1230/smpc
[x] Orajel Extra Strength. Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1231/smpc
