# Sex-Specific Oral Health: A Narrative Review of Hormonal Influences and Disease Patterns

**Authors:** Agnes Holtkamp, Florian Beuer, Thomas Gerhard Wolf, Michael Naumann

PMC · DOI: 10.3390/dj14030147 · 2026-03-06

## TL;DR

This review explores how hormones and sex differences affect oral health, highlighting the need for personalized care for men and women.

## Contribution

The paper identifies sex-specific oral health patterns and hormonal influences, advocating for tailored dental interventions.

## Key findings

- Men have higher periodontitis prevalence and lower preventive care use compared to women.
- Estrogen deficiency in women increases caries risk and affects mucosal health.
- Women maintain better oral hygiene and treatment adherence than men.

## Abstract

This narrative review aims to analyze sex-specific differences in oral health, examine hormonal influences in women during puberty, pregnancy, and menopause, and compare oral health behaviors between men and women. Articles were selected based on: (1) sex-specific aspects of oral diseases, (2) hormonal influences on oral health, (3) comparative analyses between sexes, and (4) sex-disaggregated data on oral disease prevalence. Women experience hormonal vulnerabilities with estrogen deficiency causing xerostomia, mucosal atrophy, and increased caries susceptibility, showing parallels between oral and vaginal mucosa. Men demonstrate higher periodontitis prevalence (57% vs. 38%), utilize preventive services one-third less frequently, and show higher smoking rates (67% vs. 42%) and traumatic dental injuries (2:1 ratio). Women maintain better oral hygiene and treatment adherence. Sex-specific factors affecting both sexes remain unconsidered in dental practice. Women need targeted interventions during hormonal transitions, while men require improved preventive care engagement. Future research integrating sex-specific considerations is required to enable personalized oral health approaches for both sexes.

## Linked entities

- **Diseases:** periodontitis (MONDO:0005076)

## Full-text entities

- **Genes:** IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, ESR1 (estrogen receptor 1) [NCBI Gene 2099] {aka ER, ESR, ESRA, ESTRR, Era, NR3A1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, CD79A (CD79a molecule) [NCBI Gene 973] {aka IGA, IGAlpha, MB-1, MB1}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, SRD5A2 (steroid 5 alpha-reductase 2) [NCBI Gene 6716], CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, ESR2 (estrogen receptor 2) [NCBI Gene 2100] {aka ER-BETA, ESR-BETA, ESRB, ESTRB, Erb, NR3A2}
- **Diseases:** fracture (MESH:D050723), tooth eruption (MESH:D014079), gingival recession (MESH:D005889), gingival inflammation (MESH:D007249), kidney failure (MESH:D051437), enamel erosion (MESH:D014077), endothelial dysfunction (MESH:D014652), premature labor (MESH:D007752), VVA (MESH:D014848), deficiency of 5alpha-reductase (MESH:C536415), hot (MESH:D019584), periodontal pockets (MESH:D010514), systemic diseases (MESH:D034721), pregnancy disorder (MESH:D011254), anxiety (MESH:D001007), Alzheimer's (MESH:D000544), dental injuries (MESH:D009057), membrane ruptures (MESH:D005322), temporomandibular joint disorders (MESH:D013705), fatigue (MESH:D005221), Periodontitis (MESH:D010518), burning (MESH:D002056), intrauterine growth disorders (MESH:D005317), osteoporosis (MESH:D010024), bladder infections (MESH:D001745), weight reduction (MESH:D015431), acute liver reaction (MESH:D017114), cancer (MESH:D009369), coronary heart disease (MESH:D003327), oral and pharyngeal cancer (MESH:D010610), tooth loss (MESH:D016388), overweight (MESH:D050177), candidiasis (MESH:D002177), chronic (MESH:D002908), estrogen deficiency (MESH:D056828), GSM (MESH:D014564), root caries (MESH:D017213), facial pain (MESH:D005157), proteinuria (MESH:D011507), Menopause (MESH:D008594), PE (MESH:D011225), rheumatoid arthritis (MESH:D001172), Gingivitis (MESH:D005891), dry vagina (MESH:D014625), breast, uterine, and ovarian cancer (MESH:D061325), hyperglycemic (MESH:D006944), impaired sexual function (MESH:D012734), periimplantitis (MESH:D057873), Diabetes (MESH:D003920), hypogonadism (MESH:D007006), bone density loss (MESH:D001851), dyspareunia (MESH:D004414), hyperemesis gravidarum (MESH:D006939), irritability (MESH:D001523), arthritis (MESH:D001168), cognitive decline (MESH:D003072), sleep disorders (MESH:D012893), loss of periodontal attachment apparatus (MESH:D017622), urinary incontinence (MESH:D014549), gingival and periodontal diseases (MESH:D005882)
- **Chemicals:** selenium (MESH:D012643), glucose (MESH:D005947), sugar (MESH:D000073893), vitamin B6 (MESH:D025101), carbohydrates (MESH:D002241), vitamin C (MESH:D001205), Steroid hormones (MESH:D013256), vitamin D (MESH:D014807), PGE2 (MESH:D015232), blood sugar (MESH:D001786), isoflavones (MESH:D007529), zinc (MESH:D015032), beta-carotene (MESH:D019207), fluoride (MESH:D005459), Progesterone (MESH:D011374), Testosterone (MESH:D013739), nicotine (MESH:D009538), acid (MESH:D000143), 5-dihydrotestosterone (-), bisphosphonate (MESH:D004164), prostaglandins (MESH:D011453), calcium (MESH:D002118)
- **Species:** Canis lupus familiaris (dog, subspecies) [taxon 9615], Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC13025097