Biological Injustice: Why Do Women Have Worse Teeth Than Men?

As a dentist, I am happy about every patient who comes to my practice with healthy teeth. This is especially true for women, because the burden of the “small difference” in dental health accompanies them their entire lives. According to the results of the market research institute YouGov, dental care and oral hygiene are important for 74% of women, compared to only 59% for men. 41% of women even find oral hygiene very important, compared to only 24% of men. One thing is certain: women generally live more health-conscious lives – they smoke and drink less and exercise more – they come to my practice much more often for preventative care and devote much more attention and time to their dental care.

Nevertheless, women’s teeth are often in a worse condition than those of men. My experience in practice confirms that problems with teeth are a constant, annoying issue for many women.

In many areas of health, women are definitely the stronger sex: female toddlers are less likely to get sick, and women suffer from chronic diseases only half as often.

There is only one area in which women are really the “weaker sex”, namely when it comes to dental health. However, the cause is rarely a matter of lifestyle, but rather of female biology. When it comes to dental health, a natural disadvantage for women is obvious. This realization has not been in the minds of scientists and dentists for very long, although around 50 international studies over the past 30 years have pointed to this gender gap.

Gender gap in dental health

Men are more negligent in their oral hygiene, go to the dentist less often and have more plaque. As a result, they suffer significantly more often from inflammatory gum disease. But although women practice significantly better dental hygiene, they do not have better teeth and suffer significantly more from tooth loss. Even 20-year-old women have on average one tooth less than men of this age. These differences are an international phenomenon. This is documented by studies from European countries, the USA and so-called developing countries.

When it comes to dental health, young girls between the ages of 14 and 15 are already falling behind, triggered by puberty. This biological disadvantage increases significantly over the years. The DMF-T index shows that women between the ages of 35 and 44 have 15.1 carious teeth, while men only have 14. In addition, women have to have their teeth pulled more often than men. Women tend to have fewer teeth than men. Between the ages of 65 and 74, the true extent of the unfavorable situation for us women becomes apparent with more frequent toothlessness. (The average number of missing teeth at this age is 13.3 for men, and almost 15 for women).

This has causes that cannot be explained by oral hygiene alone. The weakness of women’s teeth is obviously due to hormonal imbalances. It begins when the permanent teeth mature. Women’s teeth are therefore exposed to a caries-causing environment in the mouth for longer. In women, the composition of saliva changes during puberty due to hormonal factors: the protective effect against tooth decay is less than in men.

Hormonal fluctuations affect the teeth

Women’s gums contain receptors for progesterone and estrogen. A constant interaction between hormonal fluctuations can therefore have a direct effect on the dental environment.

There seems to be more truth in the popular saying “a pregnancy costs a tooth” than women would like. A study by Yale University in 2008 points to this: one tooth less was present per birth – and this was independent of psychosocial factors or dental care. There are many possible reasons: on the one hand, the immune system is reduced during pregnancy and the connective tissue is loosened and blood flow increases. Very often the gums show inflammatory changes during pregnancy (gingivitis) and existing periodontitis is exacerbated. The increased blood sugar level also increases the susceptibility to inflammation.

Women who are planning and wishing to become pregnant should pay particular attention to their dental health, as some dental treatments are beneficial