Does gender affect dental health? Yes, it does. For example, women tend to have better oral hygiene habits than men. They also go to the dentist more and pay more attention to what type of toothpaste they use.
However, women are also more likely to experience hormonal changes that can lead to a decline in oral health.
In this article, we'll take a deep dive into the differences between men and women, including biological and gender differences, when it comes to oral health, including:
- How certain medications affect oral health
- How gender can affect oral health habits
- Drugs and alcohol and tooth health
- Racial disparities in access to healthcare
By creating awareness of these problems, dentists and their patients alike can adjust their habits accordingly for maximum heath — oral and overall.
When it comes to tooth brushing, Women are 40% more likely than men to brush their teeth after every meal, and, according to multiple studies, more women brush their teeth twice per day than men.
It will come as no surprise then that women also tend to have better flossing habits than men — women are 26% more likely to floss daily than men are.
As far as actually going to see the dentist, men are less likely to visit the dentist regularly. This is even though women face greater financial barriers in accessing dental care than men do.
In fact, 15% of men delay getting the care they need due to cost, compared to 20% of women who put off getting treatment for financial reasons.
But, even so, according to a survey of dental visits from 1997 to 2018 based on gender, 66.8% of visits were men, and 72.7% of visits to the dentist were made by women.
Dental health problems
The sorts of dental health problems experienced by men and women may differ as well. Let's have a look at some of the main discrepancies.
Both sex and gender play a role in women's and men's responses to gum disease.
Concerning gingivitis and periodontitis — the most common varieties of gum disease — the immune response of men and women create a difference in their experiences with gum disease.
Sex hormones, like estrogen, progesterone, and testosterone all affect immunity. Testosterone can suppress an immune response and estrogen strengthens immune responses. Naturally, this has an effect on how men's and women's immune systems respond to periodontal disease.
Gender also plays a role in gum disease in men and women. Women, in general, have better oral hygiene habits than men, and they also use less tobacco, which is a drug that makes gum disease worse.
The result of these differences is that men develop gum disease at a much higher rate than women, with 56.4% of men experiencing periodontal disease compared to only 38.4% of women.
Women tend to have higher levels of cavities and decay than men. This may have to do with the fact that girls get their teeth in earlier than boys, increasing tooth exposure to the elements (in this case sugar and bacteria).
Additionally, women may experience greater deficiencies in amelogenin, which weakens the enamel and increases the risk of decay. Women also experience more fluctuations in hormone levels which affect rates of saliva flow. Less saliva can create an environment that is more welcoming to bacteria.
That being said, men have a higher risk of gum recession, which makes the tooth root more susceptible to decay.
Putting genetic predispositions aside, behavior also affects the risks of decay.
Men are less likely to visit the dentist than women are, and are less likely to brush their teeth twice per day. When they choose toothpaste, they may not pay as much attention to the kind they choose, whereas women are more likely to choose recommended brands with fluoride.
Men also have a tendency to floss less than women. Additionally, men often choose toothbrushes with harder bristles, which are more likely to damage enamel, creating a greater risk for decay.
Men are more likely to have oral cancer than women, with an alarming ratio of 2:1. That's probably because men are more likely to use tobacco, drink more, and spend more time in the sun because of having jobs working outside.
Smoking is likely the largest factor in the greater oral cancer rates among men, as smoking tobacco increases oral cancer risks up to 9 times, and even smokeless tobacco raises risks by 4 times.
Men are more likely to experience dental trauma than women with a ratio of 2:1, mostly because men have a higher engagement in contact sports or high-risk behaviors. In general, men are more likely to have physical injuries, including to the mouth, whether intentional or not.
Add to the equation that men are also less likely to mitigate injury risks by wearing mouthguards and protective gear.
Antihistamines and antidepressants may reduce the flow of saliva, creating greater instances of dry mouth and contributing to a higher risk of decay and gum disease. Then there are also medications that actually cause gums to grow more, which makes reaching plaque along the gum line more difficult.
Men are more likely to take cardiovascular medications that can cause dry mouth, due to their higher risk of cardiovascular disease. Men also have a higher occurrence of taking drugs including beta-blockers, calcium channel blockers, and diuretics, all of which increase dry mouth frequency.
Additionally, alpha-blockers may be prescribed to men for prostate health, and these can also result in dry mouth.
Drugs and alcohol
Men are more likely to use greater quantities of drugs and alcohol than women are. Alcohol affects the oral mucosa, salivary glands, and tooth enamel, with ethanol directly damaging these parts of the oral makeup.
And here's something to watch out for — men tend to use tobacco more often than women. Men also use mouthwash. Many types of mouthwash contain alcohol.
So what's the big deal? Well, alcohol actually makes it easier for carcinogens from tobacco to penetrate the oral tissues, again creating a greater risk for oral cancer. So, if you smoke, consider using a mouthwash that doesn't contain alcohol.
Women experience fluctuating hormones throughout their lives, especially during puberty, pregnancy, and menopause.
During puberty, estrogen production increases, in turn, augmenting the flow of blood to the gum tissue. During pregnancy, gum tissue can swell and there is a greater appearance of herpes and other mouth sores.
During pregnancy, the risk of lesions, tooth movement, enamel erosion, decay, and gum disease also increase.
When menstruation stops during menopause, estrogen production is also reduced. This can create changes to the oral mucosa, including dry mouth, jaw pain, and an increased risk for cavities.
Men already tend to have worse oral hygiene practices than women, including visiting the dentist less. When you combine that with the barriers that people of color face when it comes to accessing adequate dental care, the results can be catastrophic.
So, it makes sense that minority men face a disproportionate amount of oral health disparities. Black men visit the dentist less than women and white men.
Black men are also twice as likely to have decay. They also experience greater tooth loss and have a worse 5-year oral cancer survival rate when compared to white men.
Minority men are also less likely to have dental insurance, and thus it's more difficult for them to visit the dentist for restorative procedures or gum disease treatments. This means that they end up having more extractions and dentures.
In general, women have better oral health practices and behaviors than men and thus have better oral health than men.
But that doesn't mean that women are off the hook — thanks to hormonal changes they are at greater risk for gum disease and decay during puberty, pregnancy, and menopause.
The best thing that dentists can do is to take into account oral health behaviors that differ with gender identity, as well as biological factors when treating their patients, so they can adjust outreach and care accordingly.
Additionally, much more effort and resources need to be allocated to improving the oral health of minority men — widening their access to quality dental care by increasing outreach and decreasing financial barriers.
NCBI: Men and Oral Health: A Review of Sex and Gender Differences. Consulted 7th June 2022.
Statista.com: Percentage of persons with a dental visit in the past year in the U.S. from 1997 to 2018, by gender. Consulted 7th June 2022.