DENTAL HEALTH ISSUES FOR WOMEN OVER 50

By: Dr. Rashmi Shankar

There are several health concerns that arise as our population ages. An increase in chronic and systemic illness is often followed by an increase in medicines to treat these conditions. In women over the age of 50 Menopause is a specific concern with several physical manifestations. Changes associated with Menopause and a general increase in medication use can be seen in the oral cavity as well. In the following article, I will address dental concerns in treatment and as it relates to Cardiovascular disease, Diabetes, and Menopause.

Cardiovascular Disease

“Cardiovascular disease affects 1 in 7 women aged 45-64 years in the United States”.

Common oral concerns related to cardiovascular disease include orthostatic hypotension, xerostomia, and gingival overgrowth.

Orthostatic hypotension-postural hypotension, dizziness caused by suddenly standing from a seated or recumbent position. If you have cardiovascular disease and experience these symptoms, it may be prudent to sit for several minutes post dental treatment.

Xerostomia- Dry mouth. This is a common side effect of many medications. It has several compromising effects which include: dental cavities, periodontal problems, difficulty in speech and swallowing, mouth soreness, poor denture retention, increased risk of oral infection, and altered sense of taste.

Treatment of dry mouth includes the following: Frequently swishing your mouth with water. Avoiding caffeinated, sweet, or acidic beverages. Stimulating saliva with sugarless gums/ candies. For severe cases, patients can be prescribed systemic agents through their medical doctor. Finally, frequent dental visits, the application of topical fluoride, and meticulous oral hygiene are the cornerstones to management of xerostomia.

Gingival overgrowth- which will require meticulous oral hygiene, and possibly a change in medications. Other oral concerns to be evaluated and treated by your dental health care provider include; oral lesions, loss of taste, burning sensation, and angioedema. It is important to remember that you take your medications at the normally scheduled time.

Diabetes:

Recent estimates reveal that approximately 171 million people worldwide suffer from Diabetes. Type 2 diabetes is by far the most common form of diabetes. Diabetic patients are at risk of developing periodontal disease, increase rates of oral infections, delayed wound healing and a higher incidence of gingival bleeding.

These concerns are minimized by taking the proper medications as prescribed by your doctor, and by following a healthy diet. Regular dental visits and oral hygiene are necessary to monitor oral health, and minimize oral infection in patients who have diabetes.

Menopause

There are several oral symptoms associated with the onset of menopause. Among them are oral discomfort, mucosal changes, and osteopororsis. Oral discomfort includes pain, burning sensation, altered taste perception and dry mouth. Oral mucosal changes result in a change in the appearance and sensitivity of gum tissue, and at times be accompanied by an increase in bleeding gums. Lastly, osteoporosis is a condition more commonly known to affect bone health, however this condition can also make one more susceptible to periodontal disease due to lowered bone mineral density. It is important to see your dentist regularly in order to assess periodontal health, and to have regular professional cleanings in order to control gum sensitivity, swelling and bleeding.

Current recommendations include a dental exam and cleaning at least once every 6 months. Make sure to inform your dentist of any changes in your medical history. Regular dental visits and good oral hygiene can help to better manage the oral manifestations of systemic and chronic diseases. Your dental provider can also educate you on proper oral hygiene techniques, and products.

Sources:

“Women’s Oral Health Issues”. 2000 Journal of the California Dental Association.
“Diet, cardiovascular disease and oral health: promoting health and reducing risk”. Journal of the American Dental Association, Vol. 141
ADA guide to Dental Therapeutics. Third Edition.