Impact of hormonal phases on salivary characteristics and oral hygiene in women: a cross-sectional comparative study.
Level 4 - case-series / case-control
Cross-sectional comparative observational study
PubMed 41310621 · doi:10.1186/s12903-025-07284-5
What was done
A cross-sectional comparative study evaluated unstimulated salivary flow rate, salivary pH, and oral hygiene status across four hormonal states in 80 women (n=20 per group): mid-cycle (ovulatory phase), menstruating, pregnant (third trimester), and menopausal. Unstimulated salivary flow was measured over 5 minutes and reported in mL/min, pH was measured, and oral hygiene was assessed via the Simplified Oral Hygiene Index (OHI-S). Group differences were evaluated using ANCOVA with age as a covariate, followed by Tukey-adjusted pairwise comparisons of estimated marginal means.
What was found
After adjusting for age, salivary flow differed significantly across groups (F=92.10, p<0.001; partial eta-squared=0.787). Adjusted mean flow rates were 0.912 mL/min (menstruating), 0.831 mL/min (mid-cycle), 0.460 mL/min (menopausal), and 0.427 mL/min (pregnant); flow was higher in cycling groups than pregnant and menopausal groups (all p<0.001), with no significant difference between pregnant and menopausal women (p=0.980). Salivary pH also differed significantly (F=16.55, p<0.001; partial eta-squared=0.398), with adjusted means of 7.65 (mid-cycle), 7.63 (menstruating), 6.93 (pregnant), and 6.63 (menopausal); cycling groups had higher pH than pregnant and menopausal groups (most p<0.01). Age showed no significant association with flow (p=0.931) or pH (p=0.843). Oral hygiene categories differed significantly (Fisher's exact p<0.001), showing poorer hygiene in pregnant and menopausal participants.
Why it matters
This study provides comparative physiological data demonstrating that third-trimester pregnancy and menopause are linked to lower salivary volume, lower pH, and worse oral hygiene, highlighting life stages that may benefit from targeted preventive oral health strategies.
Limits
The cross-sectional design precludes causal inference. The sample size was modest (20 per group), pregnancy was only assessed in the third trimester, and unmeasured confounders including diet, medication use, socioeconomic status, and baseline oral hygiene practices were not controlled.
Cited by
- partial Salivary pH in pregnant women, older women, and individuals with dry mouth drops to 5.5 or 6.