Periodontal disease is a unique process as it has effects far reaching outside of the oral cavity. In women particularly due to hormone changes at different points of their life, periodontal infection may begin, arrest, restart and become more severe with time. The times of life are during puberty, with each pregnancy and following menopause.
Puberty
During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity and lead to greater irritations from plaque and food particles. The gums can become swollen, turn red and feel tender. Small infections called granulomas are not uncommon during this period of life, by receiving regular dental care and maintaining excellent oral hygiene this can be prevented.
Menstruation
Similar symptoms occasionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek. The symptoms clear up once the period has started. As the amount of sex hormones decrease, so do these problems.
Pregnancy
Periodontal health should be part of your prenatal care. Any infection during pregnancy, including periodontal infection, can place a baby’s health at risk.
Women’s health issue’s particularly during pregnancy and post-menopause were the center of my research interests during dental school and residency, please contact us directly if you would like to discuss the risks associated with periodontal disease and those times in your life. It has become evident that any infection including periodontal disease may have an adverse effect on the health of your new born. During pregnancy mothers affected with the bacteria associated with periodontal disease were more likely to have a small newborn or experience a pre-term birth. Screening and treatment during the pre-natal period is extremely important for anyone planning on becoming pregnant.
Osteoporosis
At the forefront of women’s health issue for women above the age of 50 years old is osteoporosis. This health issue alone results in over 100,000 fragility fractures in women alone over the age of 65 years. This poses a serious health risk to women affected with osteoporosis and many strategies have been developed by our colleagues in medicine to combat the effects of decreased overall bone mass.
As human beings our body changes throughout life both on the outside as well as on the inside. During a lifetime a person’s skeleton will go through an average of 12 full rebirths. During these changes in our life our skeletal mass changes by the following process. We have two main cells associated with bone in our bodies. One is responsible for the deposition of bone (Osteoblast) , the other is responsible for the resorption of bone (Osteoclast). Both of these cells are important as they are involved in the process of bone turnover, growth, healing and a myriad of other factors. During times of growth the Osteoblast production exceeds the rate at which the osteoclast is resorbing bone so a net gain in bone mass is occurring. However, at other times in life such as following menopause the Osteoclast is more active than the Osteoblast, a complicated orchestra of hormonal changes following menopause is responsible for that change. To combat this medicine developed Hormone replacement therapy or HRT. While being an excellent method to make the body believe that it is not postmenopausal there are other health risks associated with HRT, including an increased risk for cardiovascular problems developing such as stroke and heart attack. In an effort to minimize the cardiovascular risks associated with HRT another method for combating osteoporosis was developed. Medicine has given us wonderful drugs such as Fosamax which belongs to a category of medications called Bisphosphonate inhibitors. This class of drug directly inhibits the Osteoclast. Bisphosphonate inhibitors become irreversibly bound in the body therefore following administrating via oral or IV routes the effects of the medication are extremely long lasting. These drugs are extremely effective in helping to maintain and even increase overall bone density and bone mass. In a perfect world this would be a near perfect strategy for combating osteoporosis, however some problems have developed in patients taking these medications that are associated with dental disease and some dental treatments.
Following any event that requires healing of bone tissues such as following a dental extraction, dental implant, oral surgery or some periodontal procedures a natural progression occurs. The first step in this process is some resorption at the site of injury by the osteoclast. This cell essentially debrides and cleans the area so that the osteoblast may come in and re-deposit any lost bone in the area. In patients taking bisphosphonate inhibitors the first step is inhibited as the osteoclast function has been attenuated. Serious complications have arisen due to this inhibition of the osteoclast and it is extremely important for women considering this therapy to have a periodontal screening performed prior to beginning these medications. Please contact our office for an evaluation if you are currently taking or considering taking this medication for a screening.
Periodontal disease is a unique process as it has effects far reaching outside of the oral cavity. In women particularly due to hormone changes at different points of their life, periodontal infection may begin, arrest, restart and become more severe with time. The times of life are during puberty, with each pregnancy and following menopause. 