JDSE

The Journal of Dental Sciences and Education deals with General Dentistry, Pediatric Dentistry, Restorative Dentistry, Orthodontics, Oral diagnosis and DentomaxilloFacial Radiology, Endodontics, Prosthetic Dentistry, Periodontology, Oral and Maxillofacial Surgery, Oral Implantology, Dental Education and other dentistry fields and accepts articles on these topics. Journal of Dental Science and Education publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

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The effect of hormonal changes observed in female patients on periodontium
In women, physiological processes such as puberty, the menstrual cycle, pregnancy, oral contraceptive use, and menopause cause significant fluctuations in estrogen, progesterone, and androgen levels, increasing the inflammatory response in gum tissues and affecting the course of periodontal disease. Numerous studies in the literature have shown that hormonal changes directly affect periodontal cells, modulate inflammatory cytokine levels, and shape tissue destruction and healing processes. Furthermore, it has been emphasized that during these hormonal periods, there is an increase in the frequency of conditions such as gingivitis, periodontitis, and pyogenic granuloma seen in women. In periodontology practice, it is clear that variable hormonal conditions must be taken into account in treatment and preventive approaches for female patients. This study aimed to evaluate the effects of physiological hormonal processes in women on periodontal tissues.


1. Oh TJ, Eber R, Wang HL. Periodontal diseases in the child and adolescent. J Clin Periodontol. 2002;29(5):400-410. doi:10.1034/j.1600-051X.2002.290504.x
2. Abusleme L, Dupuy AK, Dutzan N, et al. The subgingival microbiome in health and periodontitis and its relationship with community biomass and inflammation. ISME J. 2013;7(5):1016-1025. doi:10.1038/ismej.2012.174
3. Curtis MA, Diaz PI, Van Dyke TE. The role of the microbiota in periodontal disease. Periodontol 2000. 2020;83(1):14-25. doi:10.1111/prd.12296
4. Mohanty R, Asopa SJ, Joseph MD, et al. Red complex: polymicrobial conglomerate in oral flora: a review. J Family Med Prim Care. 2019;8(11):3480-3486. doi:10.4103/jfmpc.jfmpc_759_19
5. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005;366(9499):1809-1820. doi:10.1016/S0140-6736(05)67728-8
6. Özden FO. Periodontal Hastalık Etiyopatogenezi. Ondokuz Mayıs Üniversitesi Periodontoloji Anabilim Dalı. Accessed May 24, 2026. https://avys.omu.edu.tr/storage/app/public/dis_hekimligi/129/etiyopatogenez%20ders.pdf
7. Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol. 2008;79(8 Suppl):1560-1568. doi:10.1902/jop.2008.080213
8. Cochran DL. Inflammation and bone loss in periodontal disease. J Periodontol. 2008;79(8 Suppl):1569-1576. doi:10.1902/jop.2008.080233
9. Offenbacher S. Periodontal diseases: pathogenesis. Ann Periodontol. 1996;1(1):821-878. doi:10.1902/annals.1996.1.1.821
10. Kornman KS, Page RC, Tonetti MS. The host response to the microbial challenge in periodontitis: assembling the players. Periodontol 2000. 1997;14:33-53. doi:10.1111/j.1600-0757.1997.tb00191.x
11. Preshaw PM. Host response modulation in periodontics. Periodontol 2000. 2008;48(1):92-110. doi:10.1111/j.1600-0757.2008.00252.x
12. Baltacıoğlu E, Yuva P, Aydın G, et al. Lipid peroxidation levels and total oxidant/antioxidant status in serum and saliva from patients with chronic and aggressive periodontitis: oxidative stress index: a new biomarker for periodontal disease. J Periodontol. 2014;85(10):1432-1441. doi:10.1902/jop.2014.130654
13. Altındal D, Aydınyurt C, Eskin E, Alkhatib A, Yalçın F. Van Yüzüncü Yıl Üniversitesi Diş Hekimliği Fakültesi Periodontoloji Kliniği’ne başvuran hastaların demografik verilerinin ve periodontal durumlarının değerlendirilmesi. Van Diş Hekim Derg. 2022;3(1):1-11.
14. Brown LF, Beck JD, Rozier RG. Incidence of attachment loss in community-dwelling older adults. J Periodontol. 1994;65(4):316-323. doi:10.1902/jop.1994.65.4.316
15. Sezgin Y, Nişancı Yılmaz MN. Periodontoloji kliniğine başvuran hastaların periodontal durumlarının ve sistemik hastalıklarının değerlendirilmesi. Atatürk Üniv Diş Hek Fak Derg. 2019;29(3):432-439.
16. Madden IM, Stock CA, Holt RD, Bidinger PD, Newman HN. Oral health status and access to care in a rural area of India. J Int Acad Periodontol. 2000;2(4):110-114.
17. Baelum V, Luan WM, Chen X, Fejerskov O. A 10-year study of the progression of destructive periodontal disease in adult and elderly Chinese. J Periodontol. 1997;68(11):1033-1042. doi:10.1902/jop.1997.68.11.1033
18. Özkan Şen D, Uçan Yarkaç F, Öncü E. Necmettin Erbakan Üniversitesi Diş Hekimliği Fakültesi Periodontoloji Kliniğine başvuran hastalarda periodontal hastalık farkındalığı. Selcuk Dent J. 2021;8(2):280-287.
19. Özkan Şen D, Çayır İ, Uçan Yarkaç F, Taştan Eroğlu Z. Periodontoloji kliniğine başvuran hastaların periodontal durumlarının, sistemik hastalıklarının ve kişisel alışkanlıklarının değerlendirilmesi. Necmettin Erbakan Üniv Diş Hekim Derg. 2023;5(1):10-18.
20. Türkiye Klinikleri. Sistemik durum ve periodontal hastalık ilişkileri. Türk Klin Periodontol Özel Derg. 2024.
21. Türkiye Klinikleri. Kadın hastada periodontal tedavi. Türkiye Klinikleri Periodontoloji Özel Konular. 2020. Accessed May 24, 2026. https://www.turkiyeklinikleri.com/journal/periodontoloji-ozel-konular/2149-5335/issue/2020/6/1-0/kadin-hastada-periodontal-tedavi/tr-index.html
22. Sandallı P. Periodontoloji. 2nd ed. Istanbul, Turkey: [publisher unknown]; 2007:5.
23. Mariotti A. Sex steroid hormones and cell dynamics in the periodontium. Crit Rev Oral Biol Med. 1994;5(1):27-53. doi:10.1177/10454411940050010201
24. Murakami S, Mealey BL, Mariotti A, Chapple ILC. Dental plaque-induced gingival conditions. J Clin Periodontol. 2018;45(Suppl 20):S17-S27. doi:10.1111/jcpe.12937
25. Genco RJ. Risk factors for periodontal disease. In: Cohen DW, Rose LF, Genco RJ, Mealey BL, eds. Periodontal Medicine. Hamilton, Ontario: BC Decker Inc; 2000:11-34.
26. Mealey BL, Moritz AJ. Hormonal influences: effects of diabetes mellitus and endogenous female sex steroid hormones on the periodontium. Periodontol 2000. 2003;32(1):59-81. doi:10.1046/j.0906-6713.2002.03206.x
27. Sooriyamoorthy M, Gower DB. Hormonal influences on gingival tissue: relationship to periodontal disease. J Clin Periodontol. 1989;16(4):201-208. doi:10.1111/j.1600-051X.1989.tb01642.x
28. Mascarenhas P, Gapski R, Al-Shammari K, Wang HL. Influence of sex hormones on the periodontium. J Clin Periodontol. 2003;30(8):671-681. doi:10.1034/j.1600-051X.2003.00055.x
29. Ojanotko A, Nienstedt W, Harri MP. Metabolism of testosterone by human healthy and inflamed gingiva in vitro. Arch Oral Biol. 1980;25(7):481-484. doi:10.1016/0003-9969(80)90055-2
30. Kasasa SC, Soory M. The effect of interleukin-1 (IL-1) on androgen metabolism in human gingival tissue (HGT) and periodontal ligament (PDL). J Clin Periodontol. 1996;23(5):419-424. doi:10.1111/j.1600-051X.1996.tb00568.x
31. Parkar M, Tabona P, Newman H, Olsen I. IL-6 expression by oral fibroblasts is regulated by androgen. Cytokine. 1998;10(8):613-619. doi:10.1006/cyto.1998.0336
32. Gornstein RA, Lapp CA, Bustos-Valdes SM, Zamorano P. Androgens modulate interleukin-6 production by gingival fibroblasts in vitro. J Periodontol. 1999;70(6):604-609. doi:10.1902/jop.1999.70.6.604
33. Amar S, Chung KM. Influence of hormonal variation on the periodontium in women. Periodontol 2000. 1994;6(1):79-87. doi:10.1111/ j.1600-0757.1994.tb00028.x
34. Reinhardt RA, Payne JB, Maze CA, et al. Influence of estrogen and osteopenia/osteoporosis on clinical periodontitis in postmenopausal women. J Periodontol. 1999;70(8):823-828. doi:10.1902/jop.1999.70.8.823
35. Plancak D, Vizner B, Jorgic-Srdjak K, Slaj M. Endocrinological status of patients with periodontal disease. Coll Antropol. 1998;22(Suppl):51-55.
36. Manson JD. The aetiology of chronic periodontal disease. In: Eley B, Manson JD, eds. Periodontics. London, England: Kimpton Medical Publications; 2004:38-61.
37. Lindhe J, Brånemark PI. Changes in microcirculation after local application of sex hormones. J Periodontal Res. 1967;2(3):185-193. doi:10.1111/j.1600-0765.1967.tb01888.x
38. Hofmann R, Lehmer A, Braun J, Bauer S. Activity of phagocytic granulocytes in patients with prostatic cancer. Urol Res. 1986;14(6):327-330. doi:10.1007/BF00262385
39. Ito I, Hayashi T, Yamada K, Kuzuya M, Naito M, Iguchi A. Physiological concentration of estradiol inhibits polymorphonuclear leukocyte chemotaxis via a receptor mediated system. Life Sci. 1995;56(25):2247-2253. doi:10.1016/0024-3205(95)00214-Q
40. Cheleuitte D, Mizuno S, Glowacki J. In vitro secretion of cytokines by human bone marrow: effects of age and estrogen status. J Clin Endocrinol Metab. 1998;83(6):2043-2051. doi:10.1210/jcem.83.6.4848
41. Gordon CM, LeBoff MS, Glowacki J. Adrenal and gonadal steroids inhibit IL-6 secretion by human marrow cells. Cytokine. 2001;16(5):178-186. doi:10.1006/cyto.2001.0962
42. Beagrie GS. Observation on cell biology of gingival tissue of mice. Br Dent J. 1966;121(9):417-420.
43. Chen TL, Aronow L, Feldman D. Glucocorticoid receptors and inhibition of bone cell growth in primary culture. Endocrinology. 1977;100(3):619-628. doi:10.1210/endo-100-3-619
44. ElAttar TM. Prostaglandin E2 in human gingiva in health and disease and its stimulation by female sex steroids. Prostaglandins. 1976;11(2):331-341. doi:10.1016/0090-6980(76)90155-6
45. Pack ARC, Thomson ME. Effects of topical and systemic folic acid supplementation on gingivitis in pregnancy. J Clin Periodontol. 1980;7(5):402-414. doi:10.1111/j.1600-051X.1980.tb02013.x
46. Berberoğlu A. Kadın hastalarda periodontal tedavi. Yakındoğu Üniversitesi Diş Hekimliği Fakültesi. Accessed May 24, 2026. https://docs.neu.edu.tr/staff/atilla.berberoglu/27_Kad%C4%B1nlarda%20periodontal%20tedavi_31.docx
47. Boggess KA. Maternal oral health in pregnancy. Obstet Gynecol. 2008;111(4):976-986. doi:10.1097/AOG.0b013e31816a49d3
48. Polyzos NP, Polyzos IP, Zavos A, et al. Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis. BMJ. 2010;341:c7017. doi:10.1136/bmj.c7017
49. Armitage GC. Bi-directional relationship between pregnancy and periodontal disease. Periodontol 2000. 2013;61(1):160-176. doi:10.1111/j.1600-0757.2011.00396.x
50. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci. 2006;48(4):167-175. doi:10.2334/josnusd.48.167
51. Figuero E, Carrillo-de-Albornoz A, Martin C, Tobias A, Herrera D. Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review. J Clin Periodontol. 2013;40(5):457-473. doi:10.1111/jcpe.12053
52. Machado FC, Cesar DE, Assis AV, Diniz CG, Ribeiro RA. Detection and enumeration of periodontopathogenic bacteria in subgingival biofilm of pregnant women. Braz Oral Res. 2012;26(5):443-449. doi:10.1590/S1806-83242012000500011
53. Newman M, Takei H, Klokkevold P, Carranza F. Carranza’s Clinical Periodontology. 11th ed. St Louis, MO: Mosby; 2012:414-418.
54. Otomo-Corgel J, Pucher JJ, Rethman MP, Reynolds MA. State of the science: chronic periodontitis and systemic health. J Evid Based Dent Pract. 2012;12(3 Suppl):20-28. doi:10.1016/S1532-3382(12)70006-4
55. Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Fam Physician. 2008;77(8):1139-1144.
56. Wiener RC, Wiener-Pla R. Literacy, pregnancy and potential oral health changes: the internet and readability levels. Matern Child Health J. 2014;18(3):657-662. doi:10.1007/s10995-013-1290-1
57. Bodur S, Özcan E, Gün İ. Gebeliğin periodontal hastalığı: gingivanın hamilelik tümörü. Perinatol Derg. 2010;18(2):55-58.
58. Cruz LE, Martos J. Granuloma gravidarum (pyogenic granuloma) treated with periodontal plastic surgery. Int J Gynaecol Obstet. 2010;109(1):73-74. doi:10.1016/j.ijgo.2009.11.024
59. Raber-Durlacher JE, van Steenbergen TM, van der Velden U, de Graaff J, Abraham-Inpijn L. Experimental gingivitis during pregnancy and post-partum: clinical, endocrinological and microbiological aspects. J Clin Periodontol. 1994;21(8):549-558. doi:10.1111/j.1600-051X.1994.tb01172.x
60. Offenbacher S, Katz V, Fertik G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996;67(10 Suppl):1103-1113. doi:10.1902/jop.1996.67.10s.1103
61. Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes: systematic review. J Clin Periodontol. 2013;40(Suppl 14):S181-S194. doi:10.1111/jcpe.12063
62. Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 2006;94(1):10-21. doi:10.1007/s10266-006-0060-6
63. Rosa MI, Pires PD, Medeiros LR, Edelweiss MI, Martinez-Mesa J. Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis. Cad Saude Publica. 2012;28(10):1823-1833. doi:10.1590/S0102-311X2012001000002
64. Dasanayake AP. Scaling and root planing performed on pregnant women with mild to moderate periodontal disease is not efficacious in reducing preterm birth, low birth weight, or other poor pregnancy outcomes. J Evid Based Dent Pract. 2012;12(3):135-137. doi:10.1016/S1532-3382(12)70029-5
65. Shanthi V, Vanka A, Bhambal A, Saxena V, Saxena S, Kumar SS. Association of pregnant women periodontal status to preterm and low-birth weight babies: a systematic and evidence-based review. Dent Res J (Isfahan). 2012;9(4):368-380.
66. Oppermann RV, Weidlich P, Musskopf ML. Periodontal disease and systemic complications. Braz Oral Res. 2012;26(Suppl 1):39-47. doi:10.1590/S1806-83242012000700007
67. Kayaalp SO. Oral kontraseptifler ve diğer gebelik önleme yöntemleri. In: Tıbbi Farmakoloji. 10th ed. Ankara, Turkey: Kitapçılık Ltd Şti; 2002: 1341-1355.
68. Leonard SJ. NMS Farmakoloji. Kobay S, trans. 4th ed. Istanbul, Turkey: Nobel Tıp Kitabevleri Ltd Şti; 1998.
69. Mariotti A. Dental plaque-induced gingival diseases. Ann Periodontol. 1999;4(1):7-17. doi:10.1902/annals.1999.4.1.7
70. Madianos PN, Papapanou PN, Sandros J. Porphyromonas gingivalis infection of oral epithelium inhibits neutrophil transepithelial migration. Infect Immun. 1997;65(10):3983-3990. doi:10.1128/iai.65.10.3983-3990.1997
71. Miyazaki H, Yamashita Y, Shirahama R, et al. Periodontal condition of pregnant women assessed by CPITN. J Clin Periodontol. 1991;18(10):751-754. doi:10.1111/j.1600-051X.1991.tb00068.x
72. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4(1):1-6. doi:10.1902/annals.1999.4.1.1
73. Kalkwarf KL. Effect of oral contraceptive therapy on gingival inflammation in humans. J Periodontol. 1978;49(11):560-563. doi:10.1902/jop.1978.49.11.560
74. Preshaw PM, Knutsen MA, Mariotti A. Experimental gingivitis in women using oral contraceptives. J Dent Res. 2001;80(11):2011-2015. doi:10.1177/00220345010800111201
75. Kaufert P, Boggs PP, Ettinger B, Woods NF, Utian WH. Women and menopause: beliefs, attitudes, and behaviors. The North American Menopause Society 1997 Menopause Survey. Menopause. 1998;5(4):197-202. doi:10.1097/00042192-199805040-00001
76. Paramsothy P, Harlow SD, Elliott MR, et al. Classifying menopausal stage by menstrual calendars and annual interviews: need for improved questionnaires. Menopause. 2013;20(7):727-735. doi:10.1097/GME.0b013e318279f4e2
77. Greendale GA, Lee NP, Arriola ER. The menopause. Lancet. 1999;353(9152):571-580. doi:10.1016/S0140-6736(98)05352-5
78. Burger HG, Dudley EC, Robertson DM, Dennerstein L. Hormonal changes in the menopause transition. Recent Prog Horm Res. 2002;57:257-275. doi:10.1210/rp.57.1.257
79. Saka G, Ceylan A, Ertem M, Palancı Y, Toksöz P. Diyarbakır il merkezinde lise ve üzeri öğrenim görmüş 40 yaş üzeri kadınların menopoz dönemine ait bazı özellikleri ve kalsiyum kaynağı yiyecekleri tüketim sıklıkları. Dicle Tıp Derg. 2005;32(2):77.
80. Katz IA, Epstein S. Bone mineral metabolism at the menopause: determinants and markers. In: Piero PF, ed. Humoral Factors in the Regulation of Tissue Growth. New York, NY: Springer-Verlag; 1993:211-223.
81. Trott JR. A histological investigation into keratinisation found in human gingiva. Br Dent J. 1957;103:421-427.
82. Friedlander AH. The physiology, medical management and oral implications of menopause. J Am Dent Assoc. 2002;133(1):73-81. doi:10.14219/jada.archive.2002.0025
83. Merskey H, Bogduk N. Classification of Chronic Pain. Seattle, WA: IASP Press; 1994:59-71.
84. Wardrop RW, Hailes J, Burger H, Reade PC. Oral discomfort at menopause. Oral Surg Oral Med Oral Pathol. 1989;67(5):535-540. doi:10.1016/0030-4220(89)90269-7
85. Wactawski-Wende J, Grossi SG, Trevisan M, et al. The role of osteopenia in oral bone loss and periodontal disease. J Periodontol. 1996;67(10 Suppl):1076-1084. doi:10.1902/jop.1996.67.10s.1076
86. Caufriez A. Hormonal replacement therapy (HRT) in postmenopause: a reappraisal. Ann Endocrinol (Paris). 2007;68(4):241-245. doi:10.1016/j.ando.2007.06.001
87. Ronderos M, Jacobs DR, Himes JH, Pihlstrom BL. Associations of periodontal disease with femoral bone mineral density and estrogen replacement therapy: cross-sectional evaluation of US adults from NHANES III. J Clin Periodontol. 2000;27(10):778-786. doi:10.1034/j.1600-051x.2000.027010778.x
88. Streckfus CF, Johnson RB, Nick T, Tsao A, Tucci M. Comparison of alveolar bone loss, alveolar bone density and second metacarpal bone density, salivary and gingival crevicular fluid interleukin-6 concentrations in healthy premenopausal and postmenopausal women on estrogen therapy. J Gerontol A Biol Sci Med Sci. 1997;52(6):M343-M351. doi:10.1093/gerona/52A.6.M343
89. Civitelli R, Pilgram TK, Dotson M, et al. Alveolar and postcranial bone density in postmenopausal women receiving hormone/estrogen replacement therapy: a randomized, double-blind, placebo-controlled trial. Arch Intern Med. 2002;162(12):1409-1415. doi:10.1001/archinte.162.12.1409
90. Norderyd OM, Grossi SG, Machtei EE, et al. Periodontal status of women taking postmenopausal estrogen supplementation. J Periodontol. 1993;64(10):957-962. doi:10.1902/jop.1993.64.10.957
Volume 4, Issue 2, 2026
Page : 56-65
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