Hormones and periodontal disease in menopausal women
Thursday, May 25, 2017
Hot flashes, mood changes and fatigue are just a few of the many symptoms commonly associated with menopause. Physicians can recognize its telltale signs based on a patient's medical history and age.
When symptoms interfere with the enjoyment of everyday life, doctors can prescribe hormone replacement therapy to help women adjust to these sudden changes. This therapy is more commonly prescribed today than in the past, as doctors see its additional benefit to prevent osteoporosis and other significant medical problems.
According to the Cleveland Clinic Journal of Medicine, estrogen deficiency may be to blame for the development of periodontal disease in menopausal or post-menopausal women. Physicians often see osteoporosis and bone loss in women around this age, which can also include the alveolar bone.
Loss of bone mineral density in the alveolar bone is also related to periodontal ligament loss, which causes tooth loss with age. Dentists usually become aware of a hormone problem when periodontal disease presents in those who have no previous history of the disease.
Dentists who notice a marked difference in bone density in and around the teeth in older females should inquire about the patient's last menstrual cycle. Furthermore, dental professionals need to ask about all medications, as is routine, to learn if menopausal women are receiving hormone replacement therapy. If the patient is not taking anything to replace these depleted hormones, it is likely in her best interest that she ask her physician for more information.
However, many women today want to experience menopause naturally sans medication, so broaching the topic of hormone replacement therapy may be difficult. It's best to let the facts speak for themselves — the significant drop in estrogen puts menopausal women at risk for a stroke or heart attack.
Furthermore, per the U.S. Department of Health and Human Services, hormone therapy greatly reduces a woman's risk of a bone fracture or for developing colorectal disease. Presenting patients with a total spectrum of information allows them to make the best decision for their well-being and lifestyle needs.
Oral health specialists — including dentists and periodontists — may question whether it is their place to recommend a patient seek hormone replacement therapy from a general practitioner. While hormone therapy is not a dentist's area of expertise, signs it would be beneficial may be evident in the mouth first.
For instance, a study by the Community Dentistry and Oral Epidemiology found more than 25 percent of menopausal women suffer tooth loss. Another study published this year found menopausal women to be almost twice as likely to develop severe periodontal problems if they do not undergo hormone replacement therapy.
As with any age-related topic, menopause should be discussed with sensitivity. Making a patient aware that dentists have their best needs in mind will make them more receptive to feedback and suggestions.
Prompting by the dentist can be all a patient needs to seek help. After all, hormone replacement therapy can improve their quality of life, as well as their overall health.
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