Issuu

07 issue

aug ‘22

Generations of Smiles Women’s Health ... At Every Age and Every Stage

The Puzzling Ways Oral Health Impacts Women's Health

Quality care from sea to shining sea.

Men’s Teeth Are From Mars, Women’s Are From Venus Is there a difference between the teeth and gums of men and women? On the surface, you wouldn’t think so. But delve deeper, and you’ll find that as women move from puberty to pregnancy to pensions, shifts in their hormones play a significant role in their oral health, and dentists are an important piece to the puzzle. Studies1 have found that changes in hormone levels leave women susceptible to gingivitis and periodontitis, or gum disease. These oral conditions, in turn, increase women’s risk of preterm labor2, cardiovascular disease3 and osteoporosis4, depending on their stage of life. During puberty, hormonal changes5 can increase blood flow to the gums and change the way the mouth reacts to bacterial plaque. This may leave gums tender and prone to bleeding, especially during brushing and flossing. These changes, along with poor oral hygiene and an affinity for sugar, can lead to what is called puberty-associated gingivitis6. In pregnancy, good oral hygiene is also good prenatal care. Researchers7 found that women who entered labor early were 45% more likely to have gum disease than women who carried their babies to full term. To help prevent preterm labor, experts like the March of Dimes8 encourage women to maintain their oral health, including dental checkups, during pregnancy. Menopause affects9 periodontal health by up to 60%, due to declines in estrogen. Luckily regular checkups and cleanings at this stage of life can help you combat oral decay, as well as uncomfortable hormone-related conditions such as burning mouth syndrome or dry mouth. All of this is not to suggest that men’s mouths don’t change over time. It’s just that, thanks to hormonal shifts, women’s oral health can be especially tricky. But, no matter what your stage of life, your dentist is here for you. Until next time,

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Keep smiling! It's good for the soul.

Contents The Puzzling Ways Hormonal Changes Affect Oral Health As researchers learn more about The Mouth-Body Connection®, they increasingly uncover ways in which physical health can affect oral health. This leaves women with unique challenges, as hormonal shifts over the course of a woman’s life present changing risks for gingivitis, bone loss and more.

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Differences in Oral Health Between Men & Women We study the differences in oral health and behaviors between the two genders, and whether mouth diseases are more prevalent in males or females.

page 10

Do you know your OQ? Your oral health quotient could have a big impact on your overall health. Take the test and learn how a healthier future STARTS with a healthy mouth!

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Why Your Dentist Needs to Know You Are on Birth Control Numerous birth control related factors can impact oral health. Find out what they are and why they matter for your oral health.

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Serve Day Stories See how a dental visit turned into a lot more for Donna and her husband Tom.

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The Puzzling Ways Hormonal Changes Affect Oral Health Special partnership with March of Dimes® The Riddle of the Sphinx plays on the “three stages” of a man’s life, asking “What walks on four legs in the morning, two in the afternoon and three in the evening?” The answer, famously, is “a man,” as he crawls on all fours as a baby, walks on two legs as an adult and uses a cane in old age. Cute riddle, Sphinx. But if you want a real puzzle, consider the hormonal shifts of a woman. As researchers learn more about The Mouth-Body Connection®, they increasingly uncover ways in which physical health can affect oral health. This leaves women with unique challenges1, as hormonal shifts over the course of a woman’s life present changing risks for gingivitis, bone loss and more.

HORMONES AND HEALTH Researchers who study the effects hormones have on oral and physical health emphasize that a woman’s natural changes should be viewed as a roadmap for care, not a disease to be treated. For example, recent studies2 have found that even though drops in estrogen put menopausal women at risk for gum disease, replacing that estrogen with hormone replacement therapy (HRT), doesn’t seem to help. Instead, doctors and dentists alike view a woman’s shifting hormonal makeup as a way to inform the care she should receive throughout her life. “In puberty, the way your gum tissues respond to changes, the swelling of salivary glands before a woman’s period starts, the way hormonal changes during pregnancy increase the risk of gingivitis, all of these point to the ways that women’s bodies affect their oral health,”said Dr. Deepika Dhama, a dentist based in Corona, Calif. The best defense against these changes is to brush and floss regularly, maintain your physical health and to see your dentist at least every six months.

PREGNANCY Oral inflammation has been associated with everything from diabetes to Alzheimer’s disease to cancer. So, when women keep their teeth and gums healthy, they set themselves up for better overall health. And when pregnant women keep up with their dental checkups, they set their babies up for better health, too. According to researchers3, women who entered labor early were 45% more likely to have gum disease than women who carried their babies to full term. Preterm, or premature birth affects nearly 1 out of every 10 babies4 in the U.S. and is the leading cause of infant mortality5. That is why the March of Dimes6 encourages women to take good care of their oral health during pregnancy. “At March of Dimes, we educate women and healthcare providers about the importance of oral healthcare during pregnancy,” said March of Dimes Los Angeles Executive Director Crystal Yelverton. “We’ve seen studies that show a link between gum disease and premature birth, and being pregnant can increase a woman’s overall risk for oral health problems, and these problems can affect her pregnancy.” Unfortunately, nearly 75% of pregnant women have gingivitis7, a condition that leads to periodontal disease, gum infection and tooth loss.

“It is really important to get regular cleanings during pregnancy,” “It is really important to get regular cleanings during pregnancy.” Dr. Dhama said. “It is safe, but if you are concerned, your OB-GYN may advise you to time dental care between the second and third trimesters.” MENOPAUSE “Menopause throws everything out of whack,” Dr. Dhama said, and she’s not kidding. The hormonal fluctuations associated with menopause are associated with everything from altered taste buds to burning sensations in the mouth to tooth loss, as bone density decreases. Menopause also causes dryness of the mouth, or xerostomia. Because saliva acts as a defense against cavities, dry mouths are more prone to cavities. In extreme cases, your dentist might prescribe toothpaste that includes higher levels of fluoride than what is commercially available, Dr. Dhama said. With all the oral health barriers women face, here is one more puzzling fact: women typically have healthier smiles then men. According to the American Dental Association8, women are more likely to brush after every meal, brush twice a day and see the dentist more regularly than men.

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So, what walks on four legs in the morning, two in the evening and is apparently pretty good about getting regular dental cleanings throughout her life? You guessed it, women!

March of Dimes leads the fight for the health of all moms and babies. We support research, lead programs and provide education and advocacy so that every family can have the best possible start. Building on a successful 80-year legacy, we support every pregnant person and every family.

TOGETHER, WE CAN WORK TO END PREVENTABLE MATERNAL HEALTH RISKS AND DEATH

END PREVENTABLE PRETERM BIRTH AND INFANT DEATH

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END THE HEALTH EQUITY GAP FOR ALL FAMILIES

We can all agree gender equality is a good thing, but when it comes to oral health, we have to admit that men and women just aren’t the same. 10

Now, that doesn’t have much to do with the physical aspects of a person’s mouth, male or female. Other than men generally having bigger mouths or jaw structures1 than women, there is no discernable difference in the mouths when it comes to gender. Same mouth. Same gum lines. Same number of teeth. But what is different? Simply put, it’s the risks for oral diseases and complications. These differences are

based on a combination of biologic, social and gender-related factors. WHAT WOMEN ARE MORE AT RISK FOR For women, the good news is they are more likely than men to have better oral health2 and are more likely to participate in prescribed treatment if they do have dental problems. But there are some things where women face a greater risk.

Women tend to have a higher risk for cavities based on a few reasons3: 1) Girls often have an earlier eruption in teeth, leading to a greater exposure to cavities; 2) Frequent snacking during pregnancy; 3) Genetics have also been shown to play a role. Further, because women go through hormonal changes during puberty, pregnancy, using birth control or during menopause, that also can affect their oral health4.

Men are also at a higher risk for oral cancer, tooth loss and other dental problems due to poor habits, especially tobacco use. Generally, men use tobacco at higher rates than women10, no matter if it’s cigarettes, smokeless tobacco or e-cigarettes.

Increased estrogen during puberty can increase blood flow to the gums5. Decreased estrogen during menopause can lead to dry mouth6, burning mouth syndrome and osteoporosis issues with teeth. Changes during pregnancy can lead to gingivitis, tooth loss and periodontal diseases7. Furthermore, pregnant women who have preeclampsia or gestational diabetes face their own oral health problems. WHAT MEN ARE MORE AT RISK FOR Compared to women, men are at higher risk for dental problems8 because they generally have a higher tendency to avoid the dentist, thus missing out on chances to treat cavities, gum disease and tooth decay. A National Health and Nutrition Examination Survey found that men were more likely to develop periodontal diseases9 than women (56.4% vs. 38.4%).

Using tobacco increases the risk of oral cancer by up to nine times. Combined with the fact that men are more likely to smoke, shines a light on this discrepancy. Regardless of your gender, the best thing to do for your mouth is to make sure you’re brushing twice a day, flossing and making regular visits to your dentist. Because dental problems don’t care what your gender is, and a healthy smile looks good on you whether you’re a man or a woman.

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You may know your IQ or your EQ, but do you Know Your OQ™? Take Colgate's free 10 question assessment to determine your oral health quotient. In just 2–3 minutes, you'll know your OQ score and be on your way to a healthier future.

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WHY I TELL THE DENTIST

I'm on birth control.

Any time you have a health condition or are taking medications, it’s important to let your dentist or health care professional know. But why do they need to know if you’re on birth control? We’ve explained in a prior issue of Generations of Smiles magazine1 that hormone changes can affect oral health. That’s true whether hormones levels are present in pregnancy, puberty, menopause and more. These unique hormonal changes affect the blood circulation to the mouth, leading to sensitive or bleeding gums, gingivitis or other oral problems2.

One overlooked aspect of those hormone imbalances is birth control.

A few reasons to let your dentist know you’re on birth control: • Several studies have shown that when a woman is taking some form of oral contraceptive, it often leads to poor periodontal and gingival health or increased inflammation3. But because different forms of birth control can have differing effects on oral care, it’s important to tell your dentist exactly what you’re taking and how often. • Certain prescribed medications can lower the effectiveness of oral contraceptives4. • Decreased levels of natural estrogen caused by birth control pills have been shown to cause temporomandibular (TMJ) disorders5 that affect the joint that connects your jaw to the side of your head. These reasons aren’t only for oral contraceptives. A study published in the Journal of Periodontology showed that injectable birth control led to inflammation6, plaque buildup and loss of gum tissue. So while it may seem like your birth control is none of their business, your dentist should be one of the first to know.

Serve Day S

“It made my day!”

Hear from Donna and Tom Smile Generation®-Trusted dentists and their team members are dedicated to the communities they serve. As Donna’s story illustrates, that doesn’t stop at taking care of teeth.

Healthie Happi Generations of Smiles A Smile Generation Magazine

LET'S DO THIS AGAIN! The Smile Generation exists to connect you with trusted dentists in your area and to offer education on the critical link between oral and overall health. We’d love to know what you think of our magazine.

DROP US A NOTE!

Sources The Difference in Oral Health Between Men and Women 1. Women’s health issues and their relationship to periodontitis, National Library of Medicine/National Center for Biotechnology Information, March 2002 2. Smile Generation: Generations of Smiles, August 2021 3. Smile Generation: Generations of Smiles, February 2021 4. Analysis of the relationship between periodontitis and osteoporosis/ fractures: a cross-sectional study, Springer Link, March 17, 2021 5. Hormones and Oral Health, Cleveland Clinic, June 25, 2018 6. Puberty-associated gingivitis, National Library of Medicine/National Center for Biotechnology Information, April 1992 7. Association between periodontal disease and preterm prelabour rupture of membranes, National Library of Medicine/National Center for Biotechnology Information, February 2019 8. Dental Health During Pregnancy, March of Dimes, June 2019 9. Oral Health and Menopause: A Comprehensive Review on Current Knowledge and Associated Dental Management, National Library of Medicine/National Center for Biotechnology Information, Jul-Sep 2013

The Puzzling Ways Hormonal Changes Affect Oral Health 1. Hormones and Oral Health, Cleveland Clinic, June 25, 2018 2. Sex hormone replacement therapy in periodontology-A systematic review, National Library of Medicine/National Center for Biotechnology Information, March, 2020 3. Association between periodontal disease and preterm prelabour rupture of membranes, National Library of Medicine/National Center for Biotechnology Information, March, 2020 4. Reproductive Health: Preterm Birth, CDC.org, November 1, 2021 5. Preterm birth, World Health Organization, February 19,2018 6. Dental Health During Pregnancy, March of Dimes, June 2019 7. Pregnancy and Oral Health, CDC.org, March 18, 2022 8. 2-word answers: Men vs women, Delta Dental - Grin!, Fall 2018

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The Difference in Oral Health Between Men and Women 1. Gender effect on oral volume capacity, National Library of Medicine/National Center for Biotechnology Information, November 27, 2011 2. 2-word answers: Men vs women, Delta Dental - Grin!, Fall 2018 3. Sex-Based Differences in Oral Health, Dimensions of Dental Hygiene, December 14, 2016 4. Hormones and Oral Health, Cleveland Clinic, June 25, 2018 5. Sex-Based Differences in Oral Health, Dimensions of Dental Hygiene, December 14, 2016 6. Sex-Based Differences in Oral Health, Dimensions of Dental Hygiene, December 14, 2016 7. Sex-Based Differences in Oral Health, Dimensions of Dental Hygiene, December 14, 2016 8. 2-word answers: Men vs women, Delta Dental - Grin!, Fall 2018 9. Sex-Based Differences in Oral Health, Dimensions of Dental Hygiene, December 14, 2016 10. Men and Oral Health: A Review of Sex and Gender Differences, National Library of Medicine/National Center for Biotechnology Information, May 15, 2021

Why Your Dentist Needs to Know You're on Birth Control 1. Smile Generation: Generations of Smiles, August 2021 2. Gum Disease and Women, American Academy of Periodontology 3. Impact of oral contraceptives on periodontal health, National Library of Medicine/National Center for Biotechnology Information, March 19, 2019 4. Hormones and Oral Health, Cleveland Clinic, June 25, 2018 5. Hormones and Oral Health, Cleveland Clinic, June 25, 2018 6. Birth Control Side Effects and Oral Health, Colgate.com, February 16, 2022

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