It is often said that the mouth is the gateway to overall health—and for good reason. Oral health is not just about teeth; it encompasses the condition of the mouth, gums, tongue, and other orofacial structures, enabling essential functions such as eating, speaking, and breathing. Beyond these basic functions, oral health profoundly affects psychosocial well-being, self-confidence, and the ability to interact socially or professionally without discomfort or embarrassment.
While oral health is important for everyone, women face unique challenges shaped by biological, hormonal, and life-stage factors. From puberty to menopause, these changes can affect the gums, teeth, and overall oral well-being, often compounded by gaps in awareness, preventive care, and access to dental services. Recognising these nuances is crucial to protecting women’s oral health and overall well-being.
The oral health challenge
Despite its importance, the reality is that millions around the world struggle with oral diseases. Globally, oral diseases are among the most common non-communicable diseases, affecting nearly 3.7 billion people, according to the World Health Organisation (WHO). These conditions include dental caries (tooth decay), periodontal (gum) disease, tooth loss, oral cancer, oro-dental trauma, noma, and birth defects such as cleft lip and palate.
Dental caries develops when plaque on teeth reacts with sugars from food and drinks, producing acids that erode enamel. Poor oral hygiene, inadequate fluoride exposure, and high sugar intake increase the risk. Periodontal disease affects the tissues supporting the teeth, causing swollen gums, bleeding, bad breath, and even tooth loss. Severe forms affect over a billion people worldwide. Total tooth loss, while more common in older adults, can be psychologically and socially damaging, limiting daily activities.
Oral cancer, with nearly 390,000 new cases globally in 2022, disproportionately affects men and older adults, with tobacco, alcohol, and betel quid identified as major risk factors. Other conditions, such as oro-dental trauma, noma, and orofacial clefts, further contribute to the global oral health burden, particularly in children and vulnerable populations.
In India, oral health challenges are similarly high. According to WHO’s Oral Health Country Profile 2022, untreated dental caries affect 43.3 per cent of children and 28.8 pc of those aged 5 and above. Severe periodontal disease impacts 21.8 pc of adults, while 4 pc experience complete tooth loss. Lip and oral cavity cancers caused 135,929 new cases in 2020, mostly in men. Key risk factors include tobacco (28.1 pc), alcohol (5.6 litres/year), and high sugar intake (53.8g/day). Limited access to dental care and low healthcare spending worsens the burden.
Oral health across a woman’s life stages
A woman’s oral health is closely linked to the hormonal changes she experiences throughout her life. From puberty to menopause, each stage brings unique challenges that can affect the mouth, gums, and teeth, making awareness, preventive care, and regular dental visits essential.
During puberty, rising levels of estrogen and progesterone can increase gum sensitivity, leading to redness, swelling, and bleeding. Proper brushing, flossing, and routine dental check-ups help manage these changes.
During menstruation, some women may experience gum inflammation, canker sores, or cold sores, which typically resolve on their own but should be evaluated if persistent.
According to a 2023 study, children’s oral health has modestly improved over the last two decades, yet tooth decay still affects over half of adolescents, and 26 pc of working-age adults have untreated cavities. Annual dental visits for children reached 48 pc, with Medicaid-enrolled children improving from 18 pc in 1993 to nearly 50 pc in 2018, while only about 46 pc of pregnant women receive teeth cleaning. Disparities persist due to poverty, limited health literacy, and poor integration of oral health into general healthcare.
Pregnancy can exacerbate oral health issues due to hormonal fluctuations. Around 60–75 pc of pregnant women develop gingivitis, characterised by red, swollen, and bleeding gums, which—if left untreated—can increase the risk of preterm birth and low birth weight. Some women may develop non-cancerous growths called pyogenic granulomas or “pregnancy tumours” on the gums, often between the teeth, caused by plaque irritation and increased blood flow; these usually regress postpartum. Changes in diet, morning sickness, and dry mouth can increase the risk of cavities. Maintaining good oral hygiene, staying hydrated, and visiting the dentist are crucial during pregnancy. Postpartum, mothers should continue oral care, as cavity-causing bacteria can be transmitted to infants through saliva.
Women using oral contraceptives may experience gum inflammation, delayed healing after dental procedures, and changes in salivary flow, which can increase the risk of dry socket or periodontal issues. Timing dental procedures during the non-estrogen days of the pill cycle may help minimise these effects.
During menopause and postmenopause, reduced estrogen levels can lead to dry mouth, burning sensations, altered taste, and an increased risk of osteoporosis, which may contribute to tooth loss. Hormone replacement therapy can help mitigate some of these effects. Across all stages, maintaining good oral hygiene, regular dental visits, a balanced diet, and limiting sugary foods and drinks are essential to preserve oral health and overall well-being.
In fact, a 2025 research paper included a cross-sectional study of 130 pregnant women attending a family medicine and obstetrics clinic, examining oral health and dental care utilisation. Using a self-administered questionnaire adapted from Canadian health surveys and Andersen and Newman’s framework, the study found that 73.9 pc of participants reported good or excellent oral health, while 26.2 pc reported poor or fair oral health.
Education level and quality of life were the strongest predictors of oral health status. Although 77.7 pc had visited a dentist in the past two years, only 26.9 pc had a dental visit during pregnancy. Toothbrushing frequency was the main predictor of dental visit timing. The findings highlight the need to integrate dental care into prenatal services to support maternal and child health.
Why is there a gap, and what can be done?
India faces significant challenges in oral health due to low awareness, insufficient infrastructure, and economic barriers. Strengthening preventive strategies, increasing public-private partnerships, and integrating oral health education into primary care can dramatically reduce costs and improve population outcomes. A shift from reactive to preventive care is essential for ensuring equitable and sustainable oral health solutions.
A 2019 study of 780 middle-aged rural women in Ambala (45–55 years) found 69.2 pc used toothbrush and toothpaste, yet 98 pc required dental prostheses, with significant periodontal attachment loss and high unmet dental care needs.
The human cost of neglected oral health can be tragic. In May 2025, a 32-year-old woman in Jhabua, Madhya Pradesh, died after mistakenly consuming a sulphas tablet sold to her as a painkiller for a toothache.
Dr Anand S, specialist in oral medicine and radiology at MIDAC Dental Center, Kozhikode, explained that hormonal changes play a major role in women’s oral health. “When hormones fluctuate, calcium levels in the body deplete, making teeth more vulnerable to dental caries,” he said. The gingiva, or gum tissue, is also highly susceptible to plaque accumulation, leading to gingivitis and other issues.
During pregnancy, women may even develop a condition known as pyogenic granuloma—commonly referred to as a “pregnancy tumour.” Dr Anand clarified: “It looks like a tumour, but it’s not. It’s basically gingival overgrowth that appears due to plaque irritation and increased blood flow.”
He stressed that calcium deficiency during pregnancy further increases the risk of dental caries and other oral diseases. Dental treatment during this period also comes with limitations. “Only in the second trimester are treatments considered relatively safe, and even then, we restrict them to emergency procedures. Ideally, women should resolve potential dental issues before planning pregnancy,” he noted.
Dr Anand also warned of broader health risks: untreated periodontal disease can increase the risk of conditions like endocarditis, showing that poor oral hygiene has consequences far beyond the mouth.
A major concern, according to Dr Anand, is the lack of awareness. “Most people visit dentists only when in severe pain, often relying on painkillers from local pharmacies that mask the problem and delay proper care. What starts as a small decay needing just a filling of about Rs 700 can worsen into pulpitis, requiring a root canal costing Rs 6,000–7,000,” he explained.
A survey conducted by LocalCircles, a citizen engagement platform that conducts surveys and opinion polls on public policy and social issues, which gathered responses from over 46,000 citizens across 369 districts, reveals that high costs and lack of insurance coverage deter many from seeking timely dental care. With 74 pc of respondents paying over Rs 1,500 for a single tooth filling and one in three paying more than Rs 10,000 for a root canal, the affordability crisis in dental healthcare is evident.
“While medical insurance often covers major expenses, dental care is excluded in India, forcing people to delay or avoid treatment altogether,” Dr Anand expressed. Drawing an analogy, he said: “If we can send a car for yearly servicing, why not our oral cavity? Even as a dentist, I get my mouth checked annually by a colleague because you never know what’s happening inside.”
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS.
