Can hormone replacement therapy have a positive effect on preserving
bones that support teeth in women following menopause as it is thought
to do in the rest of the body? Preliminary research at the University of
Nebraska Medical Center College of Dentistry would seem to indicate that
it can.
A two-year, $107,000 clinical research study funded by the National
Institute of Dental Research evaluated whether estrogen plays a role in
reducing periodontitis in women following menopause.
Periodontitis, an inflammation of the bone and gums which support the
teeth, causes teeth to become loose and ultimately lost. The researchers
found women with insufficient amounts of estrogen had more inflammation
and bone loss suggesting there may be increased chance of tooth loss.
Hormone replacement therapy is a drug regimen prescribed to reduce the
side effects of menopause and potential health problems associated with
menopause.
The American Academy of Periodontologys Board of Trustees selected
the research to receive its prestigious Clinical Research Award which recognizes
an outstanding published scientific manuscript with clinical relevance.
The research was selected among hundreds of international and national
research studies published in 1999 in a number of major periodontology
journals.
The study was headed by Jeffrey Payne, D.D.S., assistant dean for research
and postgraduate and graduate dental education and Rick Reinhardt, D.D.S.,
Ph.D., professor of surgical specialties. The researchers will receive
the award in September at the academys annual meeting in Hawaii.
The mouth is connected to the rest of the body, Dr. Payne said. Bone
loss may eventually lead to tooth loss. It seems some hormone replacement
therapy may protect against in tooth loss.
It may be premature, but this may be a good reason for women going
through menopause to consider talking to their physicians about estrogen
therapy, Dr. Reinhardt said. If as a patient you are trying to evaluate
whether you should take hormones, this is something you might want to put
in the plus column.
What difference can the loss of even one tooth make? Concerns may include
the cost of removing and replacing the tooth, how an individual looks with
a missing tooth should the patient choose not to replace it, as well as
the ability to chew. The molars are generally the first teeth to be lost,
Dr. Reinhardt said.
Fifty-nine women ages 45 to 60 participated in the study, all within
five years following menopause. Osteoporosis, a painful, immobilizing
disease resulting in thinner bones, progresses without symptoms or pain
until bones start to break, generally in the hip, spine or wrist. In Western
societies, more than one-third of women over age 65 suffer from signs and
symptoms of osteoporosis.
Dr. Payne said about 36 percent of adults have periodontal disease which
makes them vulnerable to losing teeth. Whereas many women lose significant
bone mass during menopause usually in their 50s and 60s, bone loss in
men occurs later. Osteoporosis occurs in men generally in their 70s and
80s.
The main cause of the disease in women is thought to be a deficiency
of estrogen, a female hormone. Risk factors for osteoporosis include: inadequate
calcium intake, physical inactivity, heavy caffeine intake, history of
chronic disease such as diabetes and hyperthyroidism, family history of
osteoporosis or fractures, underweight, pre- or post-menopausal, athletic
amenorrhea, heavy smoking, consumption of at least one drink of alcohol
each day, and consuming drugs that are known to decrease bone density.
The UNMC researchers also learned from the study that women who smoked
had a significantly higher rate of periodontitis, suggesting smoking may
place individuals at greater risk for periodontitis, which is consistent
with other research findings. The next step, say the researchers, will
be to investigate seven to eight years from now to see if those in the
study who lost bone early in menopause lose teeth or develop problems later.
The mission of the UNMC College of Dentistry is to educate dental health
professionals and to improve the health of the citizens of Nebraska through
excellence in research, education, patient care and outreach.
UNMC is the only public academic health science center in the state.
Through its commitment to research, education, outreach and patient care,
UNMC has established itself as one of the country’s leading centers for
cancer research and treatment, solid organ transplantation and arthritis.
During the past year, nearly $31 million in research grants and contracts
were awarded to UNMC scientists, and UNMCs funding from the National Institutes
of Health increased by 28 percent, going from $16.2 million to $20.7 million.
UNMCs educational programs are responsible for training more health professionals
practicing in Nebraska than any other institution.