Periodontitis and Osteoporosis Status in Postmenopausal Women; A Review

Female sex hormones are responsible for many changes in bones and oral cavity structures in a woman’s life. Postmenopause which means permanent cessation of monthly periods and happens mostly in 45-55 years age, is one of the most important hormone changing periods that influences the whole body functions. During this phase, there is a significant decrease in bone turnover and also osteoblastic and fibroblastic activity in periodontal ligaments due to lower estrogen levels in the blood. This causes rapid bone loss in first 5 years of postmenopause and there is evidence that osteoporosis is significantly more prevalent in postmenopausal women compared to men in the same age. Osteoporosis is defined as decrease of T-score to lower than 2.5 points than normal and is diagnosed by BMD (Bone Mineral Density) tests. Periodontitis is also said to be a common inflammatory disease in postmenopausal women that might cause tooth loss at end stage. It is diagnosed by clinical examination and measuring Clinical ttachment Loss (CAL) in teeth using periodontal probes. Both osteoporosis and periodontitis are painless until a noticeable irreversible destruction has occurred.Methods:We review the studies that assessed the association of postmenopause and osteoporosis and/or periodontitis. We searched PubMed and Google Scholar for related studies. Clinical studies in different designs including case reports, observational studies and cohort studies were included for the review Results:There are studies about effect of postmenopause on bone and periodontium of women. Most of studies are cross sectional and have evaluated the osteoporosis and/or periodontitis status inpostmenopausal women. There is evidence that both of the diseases are more prevalent in postmenopausal women. There are also studies which have determined possible association between osteoporosis and periodontitis which concluded controversial results. Some studies revealed that osteoporosis is a major risk factor for periodontitis and strongly indicates periodontal status in postmenopausal women. Other studies, though, claimed that there is not a direct association between the two diseases and they happen independently in bone and periodontal structures. There are also other studies which assessed the attitude and awareness of postmenopausal women about osteoporosis/periodontitis. They claim that there is not enough knowledge about periodontitis in postmenopausal women and there is need to educate them about the importance of regular checkups by periodontists and orthopedics specialist and sufficient oral hygiene instruction. Postmenopausal women are at greater risk for periodontitis and osteoporosis. These are both inflammatory diseases which are preventable and can be limited by regular medical and dental visits. More cohort studies with long follow ups are required to confirm the association between osteoporosis and periodontitis

کلیدواژه ها:

postmenopause ، women health ، osteoporosis ، periodontitis