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Menopause can be a time of tremendous anxiety for many women. As their bodies change and hormone levels rise and fall during menopause, there can be some unforeseen consequences. Many women only notice the outward changes that occur to their bodies but fail to look internally especially the changes that can occur in the mouth. These changes are quite natural but being informed can help you stay one step ahead and keep healthy through this time of change.

What Are Some Of The Potential Oral Changes With Menopause Onset?

Xerostomia (Dry Mouth). As a woman’s estrogen levels decrease it can lead to a drier mouth. Saliva is nature’s way of keeping our mouth clean and hydrated. Without sufficient amounts of saliva our teeth become more susceptible to tooth decay and periodontal infections. Dry mouth can also come from many medications (prescriptions or over the counter) that are commonly prescribed as we get older.

Menopausal Gingivostomatitis. This can occur to a very small percentage of women but can be very damaging. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red are hallmarks of this condition. Estrogen supplements are usually able to help to relieve these symptoms.

Bone Density Changes. The decrease in estrogen that occurs with menopause also puts women at greater risk for loss of bone density. Loss of bone in the jaw area can lead to tooth loss. Gum recession can also be a sign of bone loss in the jawbone. Receding gums also expose more of the tooth surface to potential tooth decay by exposing more areas of the tooth to the acids in the mouth. Gingival grafting may be necessary to cover the receding areas.

Change In Taste. This is especially true for salty, peppery or sour.

Burning Mouth Syndrome. This can affect the tongue, gum tissues, lips, and possibly the tissues inside the cheeks of the mouth. The burning mouth sensation generally occurs from changes in taste and the sensory nerves in the mouth. It can also be caused as a result of dry mouth, poor nutrition, and even allergic reactions to food or drug. If you note any of these symptoms contact your dentist immediately for help in relieving the discomfort.

Eating Disorders. Nutritional changes can occur from a woman’s change in her own body self image. These changes can lead to poor nutrition and improper eating habits. These changes can make our teeth more susceptiple to teeth damage.

How To Avoid Menopause Dental Issues?

Maintain Good Oral Hygiene. This should include brushing 2x per day, flossing, and rinsing with an antibacterial rinse. This should also include regular dental visits for routine examinations and professional cleanings.

Eat Properly. Maintaining good nutrition will help not only your oral health but your overall health as well.

Salivary Supplements. These supplements can keep the oral tissues moist and make your mouth feel better throughout the day.

Estrogen Supplements. While a controversial topic for many, the lowered estrogen levels are a main reason for the periodontal issues that arise going thru menopause.

Menopause Conclusion

Maintaining a healthy oral environment improves the quality of our lives especially as we get older. It is important for a woman to be aware of the changes happening in her body and to make the simple changes to keep on a healthy lifestyle path.

Dental implants are a highly popular dental procedure for replacing lost teeth. Dental implants are able to restore the mouth back to full function with a highly predictive, strong, long

Dental Implants Marielaina Perrone DDS

Dental Implants – The Perfect Solution For Tooth Loss

lasting restoration. However, for many, dental implants are not even an option due to poor bone density and quality of their bone.  What if dental implants were possible for these patients? Well, new research says that is possible.

Bone Break = Stronger Bone?

A recent article in the Journal of Oral Implantology suggests that the introduction of micro cracks in the jaw bones can stimulate bone growth. This would be especially helpful in patients with compromised bone density and bone quality. In theory, micro cracks can be developed in these patients and then following healing they would be able to receive their dental implants allowing for full restoration when otherwise they would not be able to.

Currently, the only way to improve bone density in patients lacking it would be the use of a dental bone graft and/or a sinus lift. These procedures require extra steps as well as extra cost. They also come with potential pitfalls such as the bone graft not taking on the first attempt.

What Did The Research Show?

The researchers used an instrument called an Osteotensor. This instrument was designed specifically for this Dental Implants Marielaina Perrone DDSdental implants study. This instrument is able to make a series of micro cracks in the jawbone in the area of the desired dental implant placement. Researchers found that, following placement of these micro cracks, there was biological response. Proteins, stem cells, and other growth factors began work to heal and regenerate the bone. The healing process is completed in about 45-90 days. At this time, the patient would be ready for dental implant placement.

The research followed the progress of a 74 year old woman who was treated with this technique. 45 days after the initial formation of micro cracks, the osteotensor instrument was unable to penetrate the bone at 23 of 42 impact sites. After 90 days, none of the sites were able to be penetrated. Softer type IV bone had been transformed into harder type II bone and it was then deemed safe to proceed with the dental implants surgery.

Dental Implant Success Is The Goal

Dental implants are currently successful over 95% of the time but for many patients their bone density and quality do not allow them to even have the option offered to them. With this new research it opens doors to allow for even more dental implant successes in the future, as well as opening the procedure up to entire new populations.

Osteoporosis…What Is It?

Osteoporosis is a disease of bones that leads to a decreased density of bone and subsequent increase in risk of fracture. In osteoporosis, the bone mineral density (BMD) is reduced, bone micro architecture deteriorates, and the amount and variety of proteins in bone are altered.

Osteoporosis is a bone weakening disease that has affected millions of people worldwide. The National Osteoporosis Foundation estimates that osteoporosis is a health threat for about 44 million people in the United States alone. The disease is far more prevalent in women than men. According to The National Osteoporosis Foundation, women are four times more likely than men to develop osteoporosis.

Because of these numbers, it is important for women to maintain a healthy lifestyle and diet even in their youth. Exercise and a proper diet for young women can help build strong bone mass for the future to avoid issues (like osteoporosis) later in life. There are recent studies showing that women who drink wine in moderation tend to have higher bone density than those who abstain from alcohol.

Medications Used for Osteoporosis and their Dental Link

Certain osteoporosis medications (also called bisphosphonates) have possibly been linked to osteonecrosis

Osteoporosis - Marielaina Perrone DDS

Normal Bone Vs. Osteoporosis Bone

(or “death of bone”) of the jaw. Osteonecrosis is bone death caused by poor blood supply to the area. It is most common in the hip and shoulder, but can affect other large joints such as knee, elbow, wrist, ankle, and jaw. Osteonecrosis is a rare and serious disease that can causes destruction of the jawbone. a condition marked by pain, swelling, infection and exposed bone. The majority of cases of osteonecrosis of the jaw involve people with cancer who have been treated with intravenous bisphosphonates. A  number of cases of osteonecrosis of the jaw have been reported in people taking oral bisphosphonates for osteoporosis. These have been primarily associated with active dental disease or a recent dental procedure, such as a tooth extraction.

Osteonecrosis can occur at any age range and can affect a wide range of ethnicity’s. Osteoporosis is considered a very serious disease and is responsible for well over 1.5 million bone fractures per year.

According to the American Dental Association (ADA), osteonecrosis of the jaw linked with osteoporosis medications has mainly been seen in cancer patients who are receiving the bisphosphonates intravenously. In fact, 94% of the cases reported are linked to intravenously-administered bisphosphonates while only 6% are linked with the oral medications.

How Do Bisphosphonates Cause These Bone Issues?

Bisphosphonates are very effective in slowing down the breakdown of bone by targeting the cells which breakdown bone (osteoclasts). An unfortunate side effect is, that they also slow down the bone cells which create new bone (osteoblasts). In areas of the body where the bones do not change much after development, (leg, hip, arm bones), this is not very disruptive. In areas such as the jaw, where bone is constantly reforming and reshaping, the lack of strong bone rebuilding cells is inhibitive to forming new bone after an extraction.

Common Bisphosphonates for Osteoporosis Treatment

Osteoporosis Fosamax Marielaina Perrone DDS

Osteoporosis Medication – Fosamax

-Fosamax

-Boniva

-Actonel

-Didronel

-Skelid

What causes Osteonecrosis?

Osteonecrosis occurs when part of the bone does not get blood and dies. After a while the bone can collapse. If this condition is not treated, the joint will deteriorate and this will become severe arthritis.

Osteonecrosis can be caused by disease, or a severe trauma, that affects the blood supply directly to the bone. Many times, no trauma or disease is present. This is called “idiopathic osteonecrosis” (which means it occurs with no known cause).

Direct Causes of Osteonecrosis:

-Long term use of steroids.

-Abuse of alcohol.

-Sickle Cell Disease.

-Radiation therapy.

-Gaucher Disease. This is a genetic disease in which a fatty substance (lipid) accumulates in cells and certain organs.

-Decompression sickness from a lot of deep sea diving

-Break, Dislocation, fractures around a joint.

Diseases Associated with Osteonecrosis:

-Gout.

-Atherosclerosis.

Diabetes.

Osteonecrosis Symptoms

-Loosening of teeth.

-Pain in the Jawbone.

-Swelling in the area affected.

-Bone becoming exposed.

-Reoccurring Infection.

Osteoporosis Conclusion

It is good to remember that osteonecrosis of the jaw bone from bisphosphonate medication use is quite rare. The drugs being used to counteract osteoporosis have proven benefits to counteract a very serious disease and reduce bone loss. If you are taking any of the bisphosphonate drugs for osteoporosis call your physician before stopping them. It is also very important to inform your dentist that you are taking such medications so they can have it in their medical history in case something arises during your course of treatment.

Maintain a proper diet, exercise regimen, along with regular visits to your dentist and physician to keep your osteoporosis under control.