Ronald C. Kobernick, DDS, MScD, PA
10601 Seminole Blvd, Largo, FL & 111 2nd Avenue NE, St. Petersburg, FL

Women and Periodontal Health

Throughout a woman’s life, hormonal changes affect tissues throughout the body.

Fluctuations in hormone levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health.


Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may swell, bleed, and become red or tender. Tissue enlargement has the potential to develop as a reaction to local irritants.


Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk.

The best way to prevent periodontal infections is to begin with healthy gums and continue to maintain your oral health with proper home care and careful periodontal monitoring.


Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. They include feeling pain and burning in your gum tissue and salty, peppery, or sour tastes.

Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of "dry mouth”.

Bisphosphonates and Osteonecrosis of the Jaw

Bisphosphonates are used for the treatment of Osteopenia and Osteoporosis and other conditions that involve bone fragility. 

Oral bisphosphonates include: Evista, Actonel, Boniva, Fosamax, Skelid, and Didronel.

Intravenous bisphosphates include: Aredia, Zometa, and Bonefos

Over the last 10 years, reports of bisphosphonate-associated osteonecrosis of the jaw (ONJ) have surfaced.  ONJ involves non-healing of bone that persists for more than 8 weeks following an Oral Surgical or Periodontal procedure in patients taking oral or IV bisphosphonates. 

Because the IV forms of bisphosphonates are much more potent than the Oral form, the risks associated for patients on the IV form are much greater. The concurrent use of steroids further increases the risk.

A smaller number of ONJ cases occur in patients taking the nitrogen-based Oral bisphosphonates, such as Fosamax, Actonel, and Boniva.  Taking these Oral medications for three years or longer increases patient risk for developing ONJ.

Prior to surgical procedures in patients taking bisphosphonates, it is important for you to share information about the medication if you are taking it, or you have a history of having used it previously.  A Serum CTX Test will be prescribed to help assess your risk. Any patient currently on IV bisphosphonates regimen is considered high risk.

Maintaining excellent home care to prevent infection and inflammation, and completing treatment prior to bisphosphonate therapy are all ways to reduce the risk of ONJ.

10601 Seminole Blvd., Largo, FL 33778 P: 727-397-8503 F: 727-398-2679

390 4th Street North, St. Petersburg, FL 33701 P: 727-397-8503