Many menopausal women find that estrogen therapy is helpful in managing any menopause related conditions, but a big benefit other this hormone treatment protocol has recently been seen to benefit the teeth and gums. Estrogen levels decrease during menopause, which leaves women susceptible to losing minerals, like calcium, that are necessary for healthy, dense bones and teeth. Additional complications from the decrease in estrogen levels include gum inflammation and periodontal disease. In fact, every 1 percent of bone density loss translates to a 4 percent increase in periodontal disease, according to the Cleveland Clinic. The Cleveland Clinic also reports that low bone density in the hips, wrist, and lumbar vertebrae show a correlation to low bone density in the jaw.
Periodontal disease begins as gingivitis, an inflammation and irritation of the gums. Gingivitis is reversible, but if left untreated, it progresses to a more serious gum condition called periodontitis. Periodontitis is the inflammation of the gum tissue that supports the teeth and the periodontal ligament that connect the teeth to the jawbone. Periodontitis is much harder to treat than gingivitis, and usually by the time it is discovered significant damage has been done, causing loose teeth and for some patients even tooth loss.
Menopause, the journal of the North American Menopause society, recently published a new study that showed the benefits of estrogen therapy to prevent periodontal disease.The study examined the link between osteoporosis treatment and severe cases of periodontitis in a group of almost 500 post-menopausal women in Brazil. The goal of the study was to determine if estrogen therapy treatment for osteoporosis improved oral health.
The group was made up of women who were undergoing estrogen therapy to treat osteoporosis-related menopause and those who were not in treatment.
"Osteoporosis depletes calcium that is necessary for strong bones, including strong jawbones," Dr. Amy Norman, D.D.S., P.C., said.
Norman is an Everett, Washington dentist who sees the impact of osteoporosis on the jaw in some patients.
"Many women who have osteoporosis also have loose teeth as a result of lost bone density of the jaw," Norman said.
The treatments were provided over a six-month period during the experiment and included either estrogen or estrogen in combination with progesterone. Both treatments included calcium and vitamin D, two supplements critical for strong bones. The study found that severe periodontal disease was reduced by almost half in women who were undergoing hormone treatment therapy compared to their peers who received no treatment.
Estrogen therapy is not a standalone treatment for post-menopausal women concerned about their oral health. Norman advises that women should make regular dental checkups a routine part of their care, no matter their age.
"Seeing the dentist at least twice per year will help to identify any problem areas and address concerns that patient maybe experiencing," Norman said.
The best combination of care, according to Norman, is seeing a physician for osteoporosis treatment in combination with seeing the dentist for regular cleanings in order to remove bacteria known to cause periodontal disease. Brushing twice per day and flossing once per day are the minimum standards of self-care patients can do at home to protect their oral health.
Many menopausal patients do not even know they are experiencing osteoporosis until they visit the dentist, according to Norman. Osteoporosis affects primarily Caucasian women over the age of 55 but can impact both women and men of all races.
Patients diagnosed by their physician as having menopause should mention their diagnosis to their dentist for monitoring.
The North American Menopause Society (NAMS). "Estrogen therapy shown effective in reducing tooth and gum diseases in postmenopausal women: Study links benefits of osteoporosis treatment with better periodontal health." ScienceDaily. ScienceDaily, 22 February 2017.
Cleveland Journal of Medicine. "How menopause affects oral health, and what we can do about it" 7 August 2009