How menopause affects oral health, and what we can do about it
ABSTRACTAfter menopause, women become more susceptible to periodontal disease. We believe the problem is due in large part to estrogen deficiency with resulting bone loss and inflammatory processes. Osteoporosis and periodontal disease are best diagnosed early so that treatment can be started sooner and fractures and tooth loss can be prevented.
KEY POINTS
- Physicians should be vigilant for dental problems and should encourage their patients to practice good oral hygiene and to seek regular dental care.
- Available information suggests that hormone therapy and bisphosphonate drugs may be developed to protect against alveolar bone loss and perhaps slow the progression of periodontal disease.
- Bisphosphonate-associated osteonecrosis of the jaw is rare, and most of the reported cases have been in cancer patients who received high doses of bisphosphonates intravenously and who had other risk factors for it.
REGULAR DENTAL CARE IS ESSENTIAL
Regardless of whether the patient is receiving a bisphosphonate drug, physicians caring for postmenopausal women should be vigilant and encourage their patients to seek regular dental evaluation for prevention and early management of oral disorders. Conversely, dentists should be aware of the potential effects of menopause and its treatments on bone and dental health.
Questions from postmenopausal women can be managed, in part, by returning to the basics suggested by the ADA:
- Regular dental examinations; regular professional cleaning to remove bacterial plaque biofilm under the gum-line where a toothbrush will not reach
- Daily oral hygiene practices to remove biofilm at and above the gum-line including brushing twice daily with an ADA-accepted toothpaste
- Replacing the toothbrush every 3 to 4 months (or sooner if the bristles begin to look frayed)
- Cleaning interproximally (between teeth) with floss or interdental cleaner
- Maintaining a balanced diet
- No smoking.
