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Oral Health; Overview.

Oral health goes far beyond having sound white teeth and no cavities. According to the first ever U.S. Surgeon General's report on Oral Health, published in 2000, the mouth (including the gums, teeth and jawbone) is a "mirror for general health and well-being."

Major oral health issues of concern to women include gum disease, dry mouth, canker sores, tooth loss and tooth decay. A growing body of research now links periodontal disease (gum disease) to heart disease, the number one killer of American women, as well as stroke, diabetes, respiratory problems and preterm, low birth-weight babies.

A significant association between obesity and prevalence of periodontal disease, especially among individuals aged 18 to 34 years, has also been established. Low dietary intake of calcium and vitamin C are cited as probable causes.

Women's oral health care needs change at specific times during the lifespan, such as during puberty, menstruation, pregnancy and menopause. Nearly one out of four women between the ages of 30 and 54 has periodontitis (an advanced state of gum disease in which the bone and gum tissue that support the teeth are breaking down). In addition, nearly half of women ages 55 to 90, who still have their teeth, have periodontitis.

Because gum disease is usually painless, many women may not even realize they have it until it reaches an advanced state (one of the warning signs is persistent bad breath or a bad taste in the mouth.) At that time, teeth may become loose and need to be extracted.

The basic principles of good oral health are quite simple, and take just a few minutes each day. Brush, floss and use a tongue scraper daily; see your dentist and dental hygienist regularly and limit snacks between meals. When your mouth and teeth are disease-free, your risks for developing other diseases throughout your life may be reduced. Don't make caring for your teeth and gums the last thing on your health to-do list.

Gum disease, a bacterial infection of tissues that support our teeth, affects three out of four adults over the age of 35. It is a major cause of tooth loss in adults, especially older Americans. According to the U.S. Centers for Disease Control and Prevention, almost three of every ten adults over age 65 have lost all of their teeth because of cavities and gum disease. The main cause of gum disease is bacteria, which is found in plaque. Plaque is a sticky colorless film that constantly forms on your teeth and tongue. Daily brushing, flossing, tongue scraping, and other forms of interdental cleaning remove plaque.

The bacteria in plaque produce toxins, which trigger an immune response, and the body releases chemicals to wall off and kill the bacteria. The chemicals produced by the body (inflammatory cytokines) cause the symptoms of gum disease. In the earliest stage of gum disease, the bacterial toxins and inflammatory cytokines cause gingivitis-a condition in which gums swell, turn red and bleed easily. Left untreated, periodontitis can develop. Periodontitis is advanced gum disease. As plaque and calculus (tartar) continue to build up, pockets form between the teeth and gums. The gums may begin to recede (pull down on lower jaw or up on the upper jaw) on the teeth. With advanced periodontitis, the periodontal pockets get deeper and the gums may recede farther. The disease destroys more gum tissue and progresses to the bone. At this late stage of gum disease, teeth (even healthy teeth) can become loose, fall out, or have to be extracted by a dentist.

How can a woman's oral health affect the health of the rest of her body? If you have gum disease, the bacteria that are present in the pockets are pumped into the bloodstream every time you chew. For most normal, healthy people, the body's immune system overcomes this bacterial attack in a controlled manner. But in some people, this dose of bacteria seems to increase their risk of other diseases that affect the body as a whole, such as heart disease, stroke, preterm low birth-weight babies, more severe diabetes and pneumonia.

There are several risk factors for heart disease, including high cholesterol, diabetes, a family history of heart disease, obesity, inactivity, high blood pressure and smoking. According to a number of studies, poor oral health could be added to that list. Evidence is mounting that suggests people with periodontal disease may be more at risk for heart disease, and have nearly twice the risk of having a fatal heart attack, as people without periodontal disease. However, this could be related to the fact that both periodontal disease and heart disease are chronic diseases that take many years to develop, so they both occur in older people. Their severity may also be linked to poor nutrition, smoking and poor health. Additionally, it may be that people who take care of their teeth also take care of other health issues.

One possibility is that when bacteria travel from the mouth into the bloodstream, they may lodge in the blood vessel walls triggering inflammation, causing the walls to thicken. A thickened blood vessel wall can increase a person's risk of heart disease, especially heart attack. Patients who have untreated gum disease can have up to three times the risk of heart disease as patients who don't have gum disease.

Another possibility is that periodontal bacteria enters the bloodstream and causes blood clots that contribute to clogged arteries. The bacteria may also cause the blood to become thicker.

In addition to heart disease, women have special oral health needs during the unique phases of their lives, such as puberty, menstruation, pregnancy and menopause. At these times, women need to be proactive with their dentist and dental hygienist and bring up general health issues for discussion. For example, if you are pregnant, or are contemplating pregnancy, it's important to treat any areas of oral infection, so they won't interfere with your baby's fetal development.

The fluctuations of female sex hormones at various stages in a woman's life cause an exaggerated response by the gums to plaque. Bacteria in plaque are the cause of gum disease. During these times, women need to be extra vigilant about brushing and flossing every day in order to prevent gum disease. Below is some specific information on what happens at each stage:

Menstruation: Just prior to or during menstruation, some women find their gums swell and bleed. Others develop cold sores and canker sores. In addition, some women find it takes longer to stop bleeding after oral surgery. The symptoms usually go away once your period starts.

Pregnancy: Up to 75 percent of all pregnant women have gingivitis. During pregnancy, hormonal changes, the lack of good daily mouth care, presence of mouth problems and dietary habits will make your mouth more susceptible to tooth decay, gingivitis and periodontal bone loss. Women may experience gingivitis (or hormonal gingivitis) beginning in the second or third month of pregnancy that can increase in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue. Also, high levels of the bacteria streptococci mutans (which causes dental decay) in pregnant women can affect the young child. New study results show that treatment with 0.05 percent sodium fluoride and 0.12 percent chlorhexidine significantly reduced salivary mutans streptococci levels in mothers and delayed the colonization of bacteria in their children for about four months.

According to the American Academy of Periodontology (AAP) evidence is mounting that suggests a possible relationship between gum disease and pre-term, low birth-weight babies. The research indicates that pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small. Low birth-weight babies have a higher incidence of breathing problems, anemia, jaundice, mental retardation, cerebral palsy, congestive heart failure and malnutrition. More research is needed to confirm how periodontal disease may affect pregnancy outcomes. One thing is for sure-periodontal disease is an infection, and all infections are cause for concern among pregnant women because they pose a risk to the health of the baby. However, also keep in mind that other women who have small babies also typically have poor nutrition, a high incidence of alcoholism and a lack of prenatal care, all of which can also contribute to periodontal disease.

Oral contraceptives: One of the most common problems in women who take oral contraceptives is hormonal gingivitis. The inflamed gums become swollen, red and bleed easily. The hormone progesterone in oral contraceptives can make your gum tissue more sensitive to irritants in the mouth, such as food or plaque. Remember, if you are taking oral contraceptives and need to take an antibiotic, the antibiotic may interfere with the efficacy of the contraceptive. Other methods of birth control are advised while taking the antibiotic.

Menopause: This normal transition, usually around the age of 50, marks the time in a woman's life when she stops menstruating. It can also signal the beginning of changes in her mouth, such as oral pain or discomfort, red or inflamed gums, burning sensations, altered taste sensations (salty, metallic, peppery, sour), dry mouth (xerostomia) and oral bone loss. The changes associated with menopause may be due to hormonal changes, calcium and vitamin deficiencies, various medical conditions and medications.

Osteoporosis: This condition is characterized by decreasing bone mass and density. Osteoporosis causes about 1.5 million bone fractures each year, with most of those affected being women. A number of studies have suggested a link between osteoporosis and bone loss in the jaw. Researchers suspect it may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation. Osteoporosis, when combined with the bacterial infection of gum disease, speeds up the process of bone loss around the tooth, which increases your risk of tooth loss.

In light of the recent research, which suggests gum disease can impact your overall health, and the fact that women have special oral health care needs at the various stages of their lives, practicing good oral health care becomes more critical than ever before.

Keywords: Parasitic myomas,Paresthesia,Pelvic Surgery,Rationalization,Sebum,Subclinical HPV,Type
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Publication:NWHRC Health Center - Oral Health
Date:Jun 13, 2005
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