Starting gender-affirming hormones does not mean your gums will start to fail. Sex hormones do act on gum tissue, and the first months of treatment may bring some short-lived changes, but no study has shown that hormone therapy causes gum disease. The factors that most affect your mouth are the same as for anyone else: plaque, smoking, dry mouth, the other medicines you take, and how often you are able to see a dentist or OHT.
Hormone therapy is managed by your prescribing doctor. Nothing in this article is a reason to pause or change it, and there is no dental reason to stop hormones before an appointment.
The research is small and recent
There are no large trials and no Australian data on oral health in people using gender-affirming hormones. What exists is a handful of small studies from the last few years, plus a much larger body of research on hormonal change in other settings such as puberty, pregnancy and menopause. That is enough to know what is worth watching. It is not enough to make firm predictions, and claims online that hormones will damage your teeth go well beyond the evidence.
Hormones change how gums respond to plaque
Gum tissue contains receptors for sex hormones, and shifts in hormone levels are well known to change how strongly the gums react to plaque. Gingivitis linked to puberty and to pregnancy are the familiar examples. The pattern in those settings is that the same amount of plaque produces more redness and bleeding, so thorough daily cleaning matters more during a period of hormonal change. Our articles on gum changes in pregnancy, menopause and oral health and the contraceptive pill and your gums describe these effects, and much of the practical advice applies here too.
What the studies on hormone therapy found
A one-year study of people starting treatment
The most direct evidence comes from a Dutch study published in the International Journal of Transgender Health (Cornejo Ulloa and colleagues, 2025), which followed 21 transmasculine and 18 transfeminine people through their first year of hormones with check-ups every three months. Saliva composition and the mix of mouth bacteria changed during the first six months and then settled by twelve months. Transmasculine participants had a short rise in gum bleeding at three months and reported changes in how often and how strongly they felt dry mouth. The authors suggest extra attention to dental care in the early stage of treatment. With fewer than 40 people, these findings are a signal, not a rule.
A review of the immune pathways
A 2024 narrative review in Frontiers in Dental Medicine (Villar and colleagues) looked at how sex and hormone therapy might affect gum disease risk. It describes preliminary findings that testosterone therapy could increase inflammatory signalling, and that oestrogen therapy, which has been studied less, may alter some immune cell activity. The authors call for more research rather than drawing clinical conclusions.
Gum health before hormones
A Brazilian study in the Journal of Oral Rehabilitation (Mélo and colleagues, 2025) examined 45 transgender adults who were not using hormones at the time. Plaque and gingivitis were common in the whole group, and jaw joint and muscle problems were frequent, linked with anxiety and alcohol use. It is a small clinic sample without a comparison group, but it is a reminder that gum health and jaw pain deserve attention whether or not someone is taking hormones.
Dry mouth deserves a mention at your visit
Saliva neutralises acid, washes away food and helps repair early enamel damage. When there is less of it, decay becomes more likely, particularly along the gum line and on exposed roots. The one-year study above recorded dry mouth changes in transmasculine participants, but hormones are rarely the only factor. A systematic review for the World Workshop on Oral Medicine (Wolff and colleagues, Drugs in R&D, 2017) found strong evidence linking several medicine groups to reduced saliva, including diuretics and many antidepressants. Spironolactone, often used as an anti-androgen in feminising regimens, is a diuretic. Smoking, vaping, alcohol, not drinking enough water and anxiety can add to dryness.
Dry mouth is usually manageable once it is known about. A dentist or OHT may suggest a higher-strength fluoride toothpaste, sugar-free gum or a saliva substitute. Our guide to dry mouth covers the options.
Bring a full medicine list
The most useful thing you can bring to a dental appointment is an accurate list of everything you take, with doses: hormones, anti-androgens, antidepressants and anything else. A photo of the packets or a printout from your pharmacy works well. It helps the dental team judge your decay risk and healing, and it matters for safe prescribing if you ever need antibiotics or pain relief after treatment.
It also helps to mention anything that affects bleeding or healing, such as blood thinners, diabetes, smoking, or recent or planned surgery. Recovering from another operation can be a reason to put off non-urgent dental work for a short time.
Smoking outweighs any hormonal effect
Smoking is one of the strongest known risk factors for gum disease and oral cancer, and it slows healing after extractions and implant treatment. Its effect on the gums is far better established than anything reported for hormone therapy. A dental team can explain what smoking is doing in your mouth and support whatever pace of change is realistic for you. Our article on smoking and oral health covers the details.
Putting off care does the most damage
In Australia's national Private Lives 3 survey, fewer than half of LGBTIQ participants said they felt accepted when using health or support services, and a poor experience can make it harder to book the next appointment. Dentally, delay turns small problems into bigger ones: a small filling becomes a root canal or an extraction, and early gum inflammation that could have settled with cleaning becomes bone loss that cannot be reversed. Regular visits, even when nothing hurts, protect your teeth more than any change to your hormones could harm them.
Your name, pronouns and records
You can ask the front desk to record your name and pronouns in your file and to use them on reminders and in the surgery. A Medicare card or health fund record may still show a former name. That is an administrative mismatch, not a question about you, and it does not need to be discussed in the surgery. If you would like the dentist to explain each step before anything goes in your mouth, or if lying back or gagging is difficult for you, say so at the start; these are ordinary requests that change how an appointment is run.
Questions people ask
Will hormone therapy give me gum disease?
No study has shown that it does. The early months may bring some temporary changes in saliva and gum bleeding, so good cleaning and regular check-ups are worthwhile, but plaque, smoking and access to care remain the main factors.
Do I have to tell my dentist I take hormones?
It is helpful, for the same reason as any other medicine: it informs questions about dry mouth, gum inflammation, healing and prescribing. You do not need to discuss anything beyond the clinical information.
Should I stop hormones before dental treatment?
No. Only your prescribing doctor should change hormone therapy. If a specific interaction ever needs checking, your dentist can contact your prescriber.
If your gums have felt more tender than usual or your mouth has been dry, the team at our Melrose Park practice can check your teeth and gums and suggest a prevention plan. You can book online, see our current offers, or let us know your name and pronouns before you arrive through our contact page. For peer support and referral, QLife is available on 1800 184 527 from 3pm to 9pm every day.
This article is general information only and is not a substitute for personal dental or medical advice. Hormone therapy is managed by your prescribing doctor, and nothing here should be used to change it. Please see a dental or medical professional about your own situation.
