Review on January 21, 2010
There is a lot of data suggesting that reduced levels of estrogen hormones in post-menopausal women affects periodontal tissues and may contribute to the onset of periodontitis in post-menopausal women, separate from the impact of insufficient estrogen hormones on alveolar bone. Outlined below is the theory that, in post-menopausal women, estrogen hormones deficiency is a risk for periodontal disease and that resulting tooth loss and use of hormone/estrogen hormones replacement therapy can prevent gum deterioration.
Throughout menopause and afterwards, the relationship between estrogen hormones shortage and tooth loss is usually explained by a chain of events started either by alveolar bone loss increased by a shortage of estrogen hormones or by periodontitis. Loss of alveolar bone in post-menopausal women leads to, among other things, retracting gum margins, and development of periodontitis.
The effect of reduced levels of estrogen hormones precisely on alveolar bone in post-menopausal women does not fully detail the relationship between a lack of estrogen hormones and tooth loss. A lot of reports have suggested a positive influence of estrogen hormones directly on periodontal tissues, despite the fact that this idea is not highlighted in current reviews of risk factors for periodontal disease in post-menopausal females.
Around 30 years ago, tooth loss was more widespread among post-menopausal women suffering from osteoporosis aged 60 to 69 years. Dr Daniell found that no post-menopausal woman had faced tooth loss during the years in which she was receiving hormone/estrogen hormones replacement therapy (H/ERT), even if she had developed osteoporosis. This suggested relatively healthy dental soft tissues in post-menopausal women during hormone/estrogen hormones replacement therapy even with reduced alveolar bone.
Other analyses have noted diminished tooth loss in post-menopausal women using estrogen hormones, diminished gingival bleeding during estrogen hormones use even after controlling for other factors contributing to periodontitis in estrogen hormones-deficient post-menopausal women. Other reviews have reported cure or prevention of gingival and periodontal disease during hormone/estrogen hormones replacement therapy. Such data indicates a capability for hormone/estrogen hormones replacement therapy in the prevention and care of post-menopausal women with periodontitis.
A common pattern continues to be nonsmoking post-menopausal women free of diabetes mellitus in their 50s and 60s with periodontal disease that significantly improves within a number of months of starting systemic estrogen hormones treatment.
The data above describes for post-menopausal women the role of estrogen hormones shortage as a risk for periodontal disease and tooth loss as well as how hormone/estrogen hormones replacement therapy could stop gum deterioration. For post-menopausal women findings from observational or small group studies link estrogen hormones deficiency to risk of soft tissue disease. Yet, the degree to which H/ERT is successful in preventing soft tissue deterioration in post-menopausal women can only be established with a placebo-controlled, randomized trial which would be somewhat unethical given that it would require leaving participants suffering from periodontal disease untreated.