What is the correlation between female sex hormones and gingiva?

There are a great number of gingival diseases that are highly impacted by the female sex hormones. These hormones can either create or play a major complicating role in these diseases. The types of such diseases can be gingiva at the time of puberty, pregnancy and menopausal times. At this times, the level of female sex hormones fo through drastic changes and might cause or accelerate the gingival situations. This hormonal changes are usually characterized by inflammation.

Gingiva condition in puberty period:

Puberty is a condition which is often showed some exaggerated responses to the gingival tissues when it relates with plaque. Pronounced type of inflammation, discoloration as bluish red type, presence of edema, and gingival enlargement may occur due to the availability of all the local factors. These local factors have the ability to create mild response to gingival tissue.

As adulthood approaches, the severity condition of the gingival tissue slowly diminishes, even at the time of local factors availability. For the complete regeneration of normal or healthy gingiva requires eradication of all the essential local factors. The dominance along with the severity of all gingival diseases is usually being increased in the period of puberty. Even though, gingivitis is not the predominant pathological condition during puberty. Through following good oral hygiene technique, this sort of pathological condition can be removed.

Menopausal gingivostomatitis (Senile atrophic gingivitis):

The usual rhythmical imbalances hormones occur during menopause where the female cycles are ended as estradiol ceases to be the major circulating estrogen. So that female can develop gingivostomatitis. This occurs during menopause or post menopausal periods.

The gingiva and other parts of the oral mucosa appear as dry and shiny. It varies in color where it ranges from abnormal type of paleness to redness. Apart from the color changes, bleeding also occurs with great ease.

Microscopically gingiva exhibits atrophy of the germinal and prickle cell layers of the epithelium and sometimes areas of ulceration.

Patient often complaints both dry and burning type of sensation that usually feels in every portion of the oral cavity. It has also been associated with greater sensitivity that may occur due to the thermal changes. Apart from the extreme level of sensitivity, patient may also experience abnormal types of sensations such as sour, peppery, salty. Patient will partial prosthesis will face difficulty due to these reasons.

Signs and symptoms are quite similar with chronic desquamative ginigivits. And it usually gets similar after ovariectomy or sterilization by radiation in the treatment of malignant neoplasm.

Hormonal Contraceptive and its affects over the Gingiva:

Hormonal contraceptives usually aggravates several types of gingiva tissue related responses due to the presence of local factors in such a way that is quite similar to the condition that has been seen in pregnancy. And if it has been taken for more than 1 and half years, the periodontal destruction level will increase.

Pregnancy induced gingivitis:

During pregnancy, estrogen and progesterone hormones’ level get higher and these increased levels of hormones induces inflammatory condition of the gingiva and eventually causes gingivitis.

Etiology of gingival tissue related responses to elevated level of estrogen and progesterone hormones during the time of pregnancy is given here:

a)Sub lingual plaque composition:-

-Increase in anaerobic: aerobic ratio.

-Availability of substantial amount of Prevotella intermedia (It also acts as the substitutes of sex hormone for the growth factor of Vit – k).

- Bacteroides melaninogenicus will be available at higher concentration.

- Porphyromonas gingivalis will be found at an extensive portion.

b)Maternal Immuno-response:-

- Cell-mediated immunity will be in decreased level.

- The function of neutrophil will be reduced, which in follow chemotaxis will be almost impaired.

 - Reduced in the level of T-cell response along with the antibody.

- Difference between CD4 and CD8 cell will be reduced where the T-suppressor cyto-toxic cell and peripheral T-helper cell will be in decreased mood.

-Cyto-toxicty has been used against the function of macrophages, and for the diminishing immune response, cyto-toxic cell will create affect of B-cel.

-Decrease substantial amount of CD4+, CD3+ and CD19+ cells that usually presents peripheral at the time of pregnancy in the peripheral blood.

-Stimulates the production level of prostaglandin.

c)Sex hormone concentration:-

1.Estrogen =>

-Increase proliferation  of cells in all types of blood vessels.

- Keratinization will be decreased, while the epithelial glycogen will be uplifted.

-Specific types of receptors will be established in the tissues of gingiva.

2. Progesterone =>

-Increase vascular dilation and thus increase permeability (resulting in edema and accumulation inflammatory cells).

-Increase proliferative activity of capillaries that are being new formed, and these are basically presented in gingival tissue. There will also increase any type of bleeding tendency.

-Collagen production rate and pattern will be changed.

- Folate’s metabolic activity will be broken down. Folate deficiency has the ability to initiate any repaid of tisshe.

-Specific types of receptors are usually being found in the tissues of gingiva.

-Decrease plasminogen activator type-2 and this usually increases proteolytic activity of tissues.

d)Estrogen hormone and Progesterone hormone:-

-Through increasing level of fluidity, it can affect the connective tissues ground substance.

-Concentration level of saliva increases and fluid where there will be increased level of serum concentrations.