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Why is Oral
Health Important for Women?
Women's oral health depends on
their different stages of life. For many women,
these changes are directly related to surges in
sex-hormone levels, such as in puberty,
menstruation, pregnancy, lactation and
menopause. Women are also more likely to be
diagnosed with TMJ, myofascial pain, eating
disorders and Sjögren's syndrome (which causes
dry mouth).
What types of
conditions will my dentist watch for?
As a woman,
you need to adhere to good oral hygiene.
Make sure to brush with fluoride toothpaste
at least twice a day and after each meal
when possible, and floss thoroughly each
day. To help avoid problems, your dentist
may request to see you more frequently
during stages of your life when hormone
levels are changing.
Bisphosphantes:
Bisphosphonates are a class
of drugs that inhibit the
resorption or breakdown of
bone tissue.
Actonel,
Aredia, Fosamax, and Zometa
are some the most popular
bisphosphonate drugs
prescribed.
Bisphosphanates are used for
the prevention and treatment
of osteoporosis, multiple
myeloma and other conditions
that involve bone fragility.
In the last 10 years,
millions of patients have
taken biphosphanates for the
prevention of osteoporosis
and bone thinning from
cancer. Bisphosphantes once
seemed safe, but lately
concerns have been raised.
Many women have been taking
bisphosphantes thinking that
these drugs were okay since
their doctors probably did
not caution them on
potential risks.
However, bisphosphante use
is now believed to be
associated with
osteonecrosis of the jaw.
Osteonecrosis of the jaw is
an uncommon complication,
but it is estimated that
among the 500,000 American
cancer patients who take the
drugs because their disease
is affecting their bones, 1
to 10 percent may develop
the problem. Some dentists
are refusing to treat
patients taking the drugs,
fearful that the dental work
will induce a case of
osteonecrosis, and lawyers
are lining up to sue the
drugs' makers, saying they
failed to give patients
adequate warning.
Cancer patients, mostly
those with multiple myeloma
and breast cancer whose
disease has spread to their
bones, generally take one of
two bisphosphonates, Zometa
or the older Aredia,
intravenously. Osteoporosis
patients usually take
bisphosphonates as pills, in
much lower doses that
patients with cancer. Those
bisphosphanate drugs ?Fosamax,
Actonel and Boniva ?reduce
the risk of fractures of the
spine or hip, injuries that
can create a steady downward
spiral in patients'
condition.
At this time, it may be too
early to know for certain
how prevalent and serious
are the risks from
bisphophanates, including
osteonecrosis, but if you
are taking them, ask your
doctor if you really need
them and whether the risks
are worth the potential
benefits. In previous issues
I mentioned that calcium
supplements at 600 mg to
1200 mg a day are
beneficial, and, of course,
exercise and weight lifting
are the most helpful.
Bisphosphantes have been
linked to Osteonecrosis of
the Jaw(ONJ).
FDA informed
dental healthcare
professionals of revisions
to the prescribing
information to describe the
occurrence of Osteonecrosis
of the Jaw (ONJ) observed in
cancer patients receiving
treatment with the
intravenous bisphosphonate,
Aredia (pamidronate disodium).
The letter also noted that
patients should avoid
invasive dental procedures
while on the drug. Novartis
first warned of the jaw
ailment in September 2004
and made doctors and
dentists aware of the side
effect.
Talk to your Dentist if you
are taking these drugs and
get a proper advise on your
Dental Treatments.
Puberty: The surge in hormones that
occurs during puberty may cause swollen
gums, especially during menstruation. Mouth
sores also can develop. Girls may experience
sensitive gums that react more to irritants.
Oral
contraceptives: Oral contraceptives
mimic pregnancy because they contain
progesterone or estrogen. Therefore gingivitis
may occur with long-term use. Women who use
birth control pills are twice as likely to
develop dry socket (a complication of tooth
extraction) and should consult their dentist
before scheduling major dental procedures.
Pregnancy:
Pregnant women have a risk for increased
inflammation of the gums because of the surge in
estrogen and progesterone. If irritating plaque
isn't removed, it can cause gingivitis – red,
swollen, tender gums that are more likely to
bleed. In some cases, large lumps called
pregnancy tumors – inflammatory, non-cancerous
growths that develop when swollen gums react
strongly to irritants. Usually these tumors
shrink soon after the pregnancy is over. Women
with periodontal disease may be at risk for
preterm, low–birth-weight babies.
If a women experiences morning
sickness, it is important to neutralize the acid
caused by vomiting, which causes tooth erosion.
Patients can use a paste made of baking soda and
water, rubbing it on the teeth. After 30
seconds, rinse off the paste, then brush and
floss. If this is not possible, rinse with
water.
Menopause: During menopause, some women
can experience dry mouth, a burning sensation
and changes in taste. Gums can become sore and
sensitive.
Other
factors: Diet pills and certain
medications (over-the-counter and prescriptions)
can decrease salivary flow, which puts patients
at risk for cavities, gum disease and
discomfort. Patients with eating disorders, such
as bulimia (self-induced vomiting) can't hide
their symptoms from their dentists because the
episodes of binging and purging cause erosion on
the backside of the upper front teeth. (An
additional sign is sores that appear at the
corners of the mouth.) Smoking also creates a
higher risk for periodontal disease.
How will my
dentist know if I have a problem?
Keep your dentist
informed if you experience changes in your oral
health or if you are approaching a different
life stage. Also, visiting your dentist
regularly will help him or her see any physical
changes in your mouth. Your dentist should
complete a thorough medical history to determine
if you are at a higher risk for problems.
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