Abstract
Background
Menopause, the absence of ovarian sex steroids, is frequently accompanied by emotional and physiological changes in a woman´s body, as well as oral health changes. The present study aimed to evaluate the association between the periodontal health status and emotional and physical well-being among postmenopausal women (PMW) in comparison with regularly menstruating premenopausal women (RMPW).
Methods
A total of 115 women (PMW, n = 56, mean age ± SD: 54 ± 5; RMPW, n = 59, mean age ± SD: 41 ± 4) received a comprehensive medical assessment and a full-mouth oral examination. All completed the Women’s Health Questionnaire (WHQ) to measure emotional and physical well-being. The corresponding bone mineral density (BMD) scores were obtained from participants´ medical records.
Results
Tooth loss was significantly higher in PMW than RMPW after adjusting for age (3.88 ± 2.41 vs 2.14 ± 2.43, p < 0.05). No significant difference was found in the prevalence of periodontitis between the two groups (PMW: 39.2%, RMPW: 32.2%, p > 0.05). The prevalence of periodontitis was associated with fewer daily brushing sessions in PMW (p = 0.021). Based on the WHQ, both PMW and RMPW with periodontitis had higher ‘’depressed mood’’ scores compared to periodontally healthy women (p = 0.06 and p = 0.038, respectively). The women who reported fewer daily toothbrushing sessions found to have higher depressive mood scores (p = 0.043).
Conclusions
Presence of periodontitis is associated with the emotional and physical well-being of women and reinforcement of oral healtcare is recommended at different stages of a woman’s life including menopause to reduce the risk for early tooth loss in women.
Background
There are several stages in a woman’s life where changes in hormone levels make them more susceptible to oral diseases, including during menstruation, pregnancy, and menopause . Menopause is a period in a woman’s lifetime, characterized by permanent cessation of menses, accompanied by major changes in sex hormone levels. The menopausal transition is frequently associated with concomitant physiological and psychological changes including vasomotor symptoms, sleep and mood disturbances . Postmenopausal changes also affect intraoral tissues, as thinning of the oral mucosa, alterations of the oral flora, and decrease of alveolar bone mineral density.
Periodontitis is a chronic inflammatory disease of supporting tissues around teeth that may lead to tooth loss due to alveolar bone resorption. It occurs as a result of a dysbiotic subgingival flora in susceptible individuals. Although increased levels of ovarian hormones, as seen in puberty, pregnancy and menstruation, can result in an increase in gingival inflammation and microbial changes in dental plaque, contrariwise, during menopause, a lack of hormones can also lead to poor periodontal health. Hormonal changes and decreased bone mineral density are proposed to increase predisposition towards alveolar bone loss in postmenopausal women. Previous studies estimated menopause as a risk factor for periodontitis. However, controversial results were reported. So far, there is no consensus for an increased risk of periodontitis after menopause.
Individuals under emotional stress are more likely to develop periodontitis. Women are shown to be more prone to mental illnesses compared to men, representing a two-fold greater incidence. Furthermore, the menopausal transition puts women at greater risk for depression. Quality of life and psychological stress factors need to be investigated as confounders in oral health evaluations of postmenopausal women.
We hypothesized that certain psychosomatic characteristics could characterize women at greater risk of poor oral health before or during menopause. This study aimed to investigate the relationship between clinical periodontal health and physical and emotional symptoms extracted by Women’s Health Questionnaire (WHQ) scores, in postmenopausal women (PMW), in comparison with regularly menstruating premenopausal women (RMPW). We also evaluated systemic bone mineral density as a modifying factor of periodontitis in PMW.
Methods
Participants
This cross-sectional cohort study included 115 women with an age range of 35–65 years. The study was conducted
