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EFFECTS OF PREGNANCY & PUBERTY

A MOUTHFUL OF REASONS TO CONSIDER HORMONE REPLACEMENT THERAPY

CHICAGO – August 30, 1999 – Postmenopausal women weighing the pros and cons of hormone replacement therapy may be able to add another benefit to their list – protecting their teeth. A study published in the current issue of The Journal of Periodontology released today suggests that estrogen supplementation in women within five years of menopause may slow the progression of periodontal disease.

Studies show that at least half of Americans older than age 55 have periodontitis (an advanced stage of periodontal disease). Researchers have suspected that estrogen deficiency and osteopenia/osteoporosis speed the progression of oral bone loss following menopause, which could lead to tooth loss. The newly released study concluded that estrogen supplementation may lower gingival inflammation and the frequency of attachment loss (destruction of the fibers and bone that support the teeth) in women with signs of osteoporosis, thus helping to protect the teeth.

About 25 million of this country's older women suffer bone loss due to osteoporosis. Estrogen supplementation is credited with helping to prevent bone loss, alleviating common menopause symptoms (such as hot flashes and irritability) and reducing the risk for coronary artery disease.



RESEARCH PRESENTED TODAY PROVIDES FURTHER EVIDENCE ON THE IMPORTANCE OF GOOD ORAL HEALTH IN PREGNANT WOMEN

WASHINGTON, D.C. – May 7, 2000 – The more of the mouth affected with periodontal disease, the more likely a woman is to deliver a premature baby, according to an ongoing study of more than 2,000 pregnant women. The results point to further evidence that periodontal disease may be a significant risk factor for preterm births.

Past studies have shown that women with periodontal disease may be up to seven times more likely to deliver a preterm low birth weight baby. Today at the American Academy of Periodontology's Specialty Conference on Periodontal Medicine in Washington, D.C., preliminary research was presented for the first time suggesting that the risk for women who have generalized periodontal disease (meaning it affects at least 30 percent of their mouth) is even higher.

The women in the study had no other major risk factors for preterm birth, including genitourinary infections, tobacco use, and alcohol consumption. In the United States, about 25 percent of preterm births occur without any known risk factors.



PROTECTING ORAL HEALTH THROUGHOUT YOUR LIFE


As a woman, you know that your health needs are unique. You also know that at specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. Did you know that your oral health needs also change at these times?

While women tend to take better care of their oral health than men do, women's oral health is not markedly better than men's. This is because hormonal fluctuations throughout a woman's life can affect many tissues, including gum tissue.

A study published in the January 1999 issue of the Journal of Periodontology reports that at least 23 percent of women ages 30 to 54 have periodontitis (an advanced state of periodontal disease in which there is active destruction of the periodontal supporting tissues). And, 44 percent of women ages 55 to 90 who still have their teeth have periodontitis.

Because periodontal disease is often a "silent" disease, many women do not realize they have it until it reaches an advanced state. However, at each stage of your life, there are steps you can take to protect your oral health.


PUBERTY

During puberty, an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum's sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender.

As a young woman progresses through puberty, the tendency for her gums to swell in response to irritants will lessen. However, during puberty, it is important to follow a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.


MENSTRUATION

Occasionally, some women experience menstruation gingivitis. Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman's period and clears up once her period has started.


PREGNANCY

Women may experience increased gingivitis or pregnancy gingivitis beginning in the second or third month of pregnancy that increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.

In some cases, gums swollen by pregnancy gingivitis can react strongly to irritants and form large lumps. These growths, called pregnancy tumors, are not cancerous and are generally painless. If the tumor persists, it may require removal by Dr. Raschkovsky.

Studies have shown a relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small! If you are planning to become pregnant, be sure to include a periodontal evaluation as part of your prenatal care.

Women who use oral contraceptives may be susceptible to the same oral health conditions that affect pregnant women. They may experience red, bleeding and swollen gums. Women who use oral contraceptives should know that taking drugs sometimes used to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.

More information about pregnancy and periodontitis.


MENOPAUSE AND POST-MENOPAUSE

Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.

Bone loss is associated with both periodontal disease and osteoporosis. Research is being done to determine whether the two are related. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth as well as other parts of the body.

More information about Hormone Replacement Therapy and Periodontal Disease.


STEPS TO PROTECT ORAL HEALTH

Careful periodontal monitoring and excellent oral hygiene is especially important for women who may be noticing changes in their mouths during times of hormonal fluctuation. To help ensure good oral (and overall) health, be sure to:

o See a dental professional for cleaning at least four times a year.
o See Dr. Raschkovsky if you or your dentist notice problems with your gum tissue. Problems may include:

o Bleeding gums during brushing
o Red, swollen or tender gums
o Gums that have pulled away from the teeth
o Persistent bad breath
o Pus between the teeth and gums
o Loose or separating teeth
o A change in the way your teeth fit together when you bite
o A change in the fit of your dentures

Keep your dental professionals informed about any medications you are taking and any changes in your health history.
Brush and floss properly every day. Review your techniques with a dental professional.


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