Sex plays a bigger role in dental health than most people think. A major US study has mapped out how men and women differ across more than 200 dental, oral, and craniofacial conditions. The team used millions of health records to spot these patterns. Their work is already forcing a rethink about who gets which oral diseases and why.
A global study published in The Lancet Public Health in September 2026 found that while the age-standardised prevalence of major oral diseases declined by 1.55% between 2019 and 2023, the absolute number of people affected worldwide continued to rise.
The results stand out. In the All of Us dataset, just over two-thirds of conditions with sex-specific data showed clear differences between men and women. Slightly more of these leaned female, but many showed a male bias. Women were more likely to be diagnosed with recurrent aphthous stomatitis, aphthous ulcers, dry mouth (xerostomia), and several problems with tooth development and eruption. Dental abscess, reversible pulpitis, toothache, and some types of periodontitis also showed up more in women. On the other hand, men were more likely to have generalised and localised moderate periodontitis, lose teeth from local periodontal disease, and get pit-and-fissure caries that reach the dentine or pulp. Oral cancers also showed a male bias.
The BigMouth dataset told a slightly different story. Here, about two-fifths of conditions with sex-specific data showed significant differences, and almost all of these were more common in women. Women were more likely to have enamel, dentine, and cementum defects, dry mouth, symptomatic apical periodontitis, symptomatic reversible pulpitis, and temporomandibular disorders. For men, the main conditions were oral malignant neoplasm, generalised severe aggressive periodontitis, and root caries. But the two datasets did not always match. Of 20 diagnostic terms found in both, eight showed the opposite sex bias-especially for generalised moderate and localised chronic periodontitis, as well as tooth abrasion and attrition.
Sex differences in oral health are influenced not only by biology, but also by hormonal, behavioural, and medical factors. Recent reviews highlight that women may be more susceptible to periodontal issues during certain hormonal periods, and that the prevalence of gingival inflammation can differ significantly between sexes.
These findings call for a new approach to oral health. The evidence shows that prevention, diagnosis, and treatment should not be the same for everyone. Instead, they should match the different risks men and women face. Still, the authors warn that more research in diverse groups is needed before these insights can shape clinical guidelines.
For those following oral health research, this study joins other recent pushes to personalize care, like the oral microbiome focus reported earlier. The trend is clear: generic dental advice is being replaced by a more detailed, evidence-based approach.
As the field takes in these results, one thing is clear. Sex-based differences in oral disease are not a side note-they are a main challenge for researchers and clinicians. The old idea that men and women share the same oral health risks is fading. The real question now is whether dental education, research, and practice can move fast enough to give patients the tailored prevention and care they need.
