Dentists Who Want to Survive Must Pay Attention to Women’s Issues
BINGHAM FARMS, Michigan — A dentist who ignores the needs of more than half of the clients that walk into the door will not stay in business long. Common sense, at least, suggests that.
Yet many dental practices either ignore or underplay the special oral health concerns related specifically to women, especially during different life stages.
Dr. Timothy Kosinski, DDS, of SmileCreator in Bingham Farms, Michigan has practiced for more than 20 years because he pays special attention to women issues as well as being a recognized expert on dental implants and smile creation.
“There are certain oral health concerns related specifically by women, especially during different stages of her life,” says Dr. Kosinski. “In general, women are more likely than men to be diagnosed with eating disorders, TMJ, Myofacial Pain Syndrome and/or dry mouth. And a woman cannot maintain dental health if attention is not paid to such things as puberty, menstruation, oral contraceptives, pregnancy and menopause.”
Among the issues women face that impact dental health are:
During puberty, a young woman’s production of the sex hormones progesterone and estrogen increases. This surge in hormones may contribute to swollen/sensitive gums and Herpes-type lesions and ulcers. During menstruation periods, these symptoms may become magnified.
Oral contraceptives contain either progesterone or estrogen and, therefore, may mimic pregnancy dental symptoms such as bleeding, swollen and sore gums. Women using oral contraceptives have a much greater chance of developing a painful condition known as “dry socket” after an extraction. Be sure to inform your dentist if you are using oral contraceptives and having a tooth extracted.
Pregnant women often experience bleeding, swollen and painful gums, or sometimes a “pregnancy tumor,” which is a benign growth that usually shrinks when the pregnancy is over. It is extremely important for pregnant women to practice regular and efficient oral hygiene to minimize these symptoms. There is some research that suggests that periodontal disease can result in pre-term deliveries and/or low birth-rate babies.
Post-menopausal women often develop a debilitating condition called burning mouth syndrome, which can be painful and peak at night making sleep difficult. Other symptoms common to post-menopausal women are dry mouths and changes in taste.
Most of these symptoms are relieved by estrogen supplements but this hormone replacement therapy can cause bleeding, tender, swollen gums. Estrogen replacement therapy helps maintain the mineral density of the jawbone, reducing the risk of tooth loss. Check with your dentist and physician if these symptoms persist to determine the best course of treatment.
Medications such as diet pills, antihistamines, some blood pressure drugs and antidepressants can cause a decrease in salivary flow. A chronic dry mouth may put you at risk for developing cavities and gum disease. Check with your dentist for a diagnosis and alternative remedies.
Dr. Kosinski says it is also important that a dentist also must discuss with female patients how dental health relates to treatments for osteoporosis, low-carb diets, eating disorders, and cautions about dental X-rays during pregnancy.
Osteoporosis, a progressive loss of bone mass due to aging, makes women more susceptible to fractures and possibly loss of teeth from weakening of the jawbone. Osteoporosis risk factors include lack of calcium, smoking cigarettes, excessive use of alcohol, being Caucasian or Asian, early estrogen deficiency and having a thin, small-boned frame.
For women age 19-24, the recommended daily allowance of calcium is 1,200 milligrams which decreases to 800 milligrams thereafter. Foods rich in calcium include milk, cheese and ice cream but these also are high in calories and fat.
Alternatives such as skim or no fat milk are preferable. There are a reasonable variety of cheeses and yogurts that are low fat as well as ice cream substitutes. Besides dairy, other healthy foods rich in calcium are salmon, tofu (soybean curd), broccoli, peas, beans, nuts and calcium-enriched grain products.
Low-carb diets such as the Atkins and South Beach diets have become increasingly popular as effective ways of shedding those unwanted pounds. However, one must take care not to simultaneously shed your friends because of bad breath.
By limiting your intake of bread, cereal, pasta, fruits, rice, ice cream, cakes and other foods, the body will burn stored fat as fuel for energy rather than carbohydrates. Strict adherence to these types of diets will send your body into “ketosis.” Chemicals known as ketones are released when the fat is burned and are excreted from the body through the urine and the saliva. This will result in halitosis or bad breath.
The bad breath that can result from low-carb diets is not the same type of odor that comes from poor oral hygiene, allowing bacteria to break down proteins into sulfur gas, so additional brushing, flossing and scraping the tongue will not alleviate the problem.
If the “ketone breath” becomes a problem, the person must modify the diet or try to mask the symptoms until the desired weight loss is achieved. Some suggestions are to drink plenty of water, chew on parsley, suck on sugarless mints and/or chew on sugarless gum.
Eating disorders, especially bulimia, can be harmful to the teeth. From constant vomiting, the enamel and dentin coverings on the back of the upper front teeth surfaces will erode. The amount of erosion depends on the frequency and degree of vomiting.
And when the back teeth are affected there will be a change in the bite from the loss of tooth structure. Another problem common with bulimics is swelling of the parotid gland. Bulimia also can result in having a dry mouth because of dehydration from fasting and vomiting and abuse of laxatives and diuretics.
Pregnancy is something a dentist should be informed about because the American Dental Association strongly recommends that pregnant women postpone elective x-rays until they have given birth. There are, however, instances during pregnancy that x-rays may be required to assist diagnosis or treatment of dental disease.
In situations where x-rays are necessary, protective leaded aprons with thyroid collars should be used to minimize radiation exposure, thus preventing harm to the fetus or child. Studies have shown that women having dental x-rays during pregnancy have a greater potential to give birth to smaller-than-normal babies. But remember, maintaining oral health throughout the pregnancy is critical to both the total health of the expectant mothers and to the health of their babies.
For more information about Dr. Kosinski or SmileCreator go to www.smilecreator.net, call 248-646-8651 or send an email query to allquestions@smilecreator.net. SmileCreator is located at 31000 Telegraph Rd., Suite 170, Bingham Farms, MI 48025.
About Dr. Timothy Kosinski: He has practiced general and implant dentistry for 20 years. A graduate of University of Detroit Dental School, he completed comprehensive implant training at Harvard. He is a Diplomate of the American Board of Oral Implantology/Implant Dentistry, The International Congress of Oral Implantologists and the American Society of Osseointegration. He is a Fellow of the American Academy of Implant Dentistry and most recently received his Mastership in the AGD in Anaheim this year. Dr. Kosinski has been inducted into the American and International Colleges of Dentists and the Academy of Dentistry International. Dr. Kosinski was selected the Best Dentist in America by his peers in 2004-2005.