Women’s Issues

Calcium: An Important Dietary Need for Women

While both men and women require an appropriate amount of calcium to build bone mass during their early developmental years, women have a greater risk of developing osteoporosis, a progressive loss of bone mass due to aging. This makes women more susceptible to fractures and possibly loss of teeth from weakening of the jawbone. Osteoporosis, also know as the “Silent Disease,” because it has no symptoms has other risk factors, including smoking cigarettes, excessive use of alcohol, being Caucasian or Asian, early estrogen deficiency and having a thin, small-boned frame. For women in the age range of 19-24 years, the recommended daily allowance (RDA) of calcium is 1,200 milligrams. This decreases to 800 milligrams thereafter. Foods rich in calcium include milk, cheese and ice cream, but these also are high in calories and fat. So, shop wisely and check the labels. Alternatives such as skim or no fat milk will solve the problem. 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.

Eating Disorders

Several researchers have conservatively estimated that there are 1-5 million girls and women and 1 million boys and men in the United States that suffer from some type of eating disorder after puberty. While a preoccupation with food and weight is evident with those who exhibit an eating disorder, often their behavior is compensating for strong feelings and emotions that seem overwhelming. Both emotional and physical health can be adversely affected. According to information on the National Eating Disorders Association’s website, [www.NationalEatingDisorders.org], 42% of 1st and 3rd grade girls want to be thinner, 46% of 9-11 year-olds are “sometime” or “very often” on diets, 45% of American women are on a diet on any given day, 80% of American women are dissatisfied with their appearance. Three of the more common eating disorders are Anorexia Nervosa [characterized by excessive weight loss and self-starvation], Bulimia Nervosa [characterized by binge eating followed by purging] and Binge Eating Disorder [characterized by impulsive eating and excessive weight gain]. Bulimics are very good at hiding their disorder. However, there are classic oral manifestations of this disorder. From constant vomiting, the enamel and dentin coverings on the back of the upper front teeth surfaces become eroded. Clinically, the tooth surface has a smooth, glassy appearance without any stains. The amount of tooth erosion is related to the frequency and degree of vomiting. When the back teeth are affected, there is a change in the bite from loss of tooth structure. Swelling of the parotid gland is also common in bulimics. Another frequent consequence of bulimia is having a dry mouth because of dehydration from fasting and vomiting and abuse of laxatives and diuretics. Patients suspected of bulimia should be referred to mental health professionals who are experienced in eating disorders. From a dental standpoint, these patients should come in for regular professional cleanings and practice meticulous oral hygiene and home care. They should rinse vigorously with water immediately after vomiting; the use of “artificial saliva” and daily application of fluoride in custom trays will also help minimize damage to the teeth and gums. Elective cosmetic treatment should not be attempted during the active phase of this disorder.

Low-Carb Diets and Bad Breath

The Atkins Diet, South Beach and other low-carb diets have become increasingly popular as effective ways of shedding those unwanted pounds. However, one must take care not to simultaneously shed your friends. 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 know 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. It is not the same type of odor that comes from poor oral hygiene, allowing bacteria to breakdown proteins into sulfur gas, so additional brushing, flossing and scraping the tongue will not alleviate the problem. If the “ketone breath” becomes a problem, one 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.

Pregnancy and Dental X-Rays

It’s important that women visiting their dentist for annual check-ups or emergency treatment inform the dental office if they are pregnant, trying to become pregnant and/or might be pregnant. The American Dental Association strongly recommends that pregnant women postpone elective x-rays until they have given birth. They note, however, that there are 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.

Women’s Dental Health Issues

There are certain oral health concerns related specifically to women, especially during different stages of her life. In general, women are more likely than men to be diagnosed with eating disorders, TMJ, Myofacial Pain Syndrome and/or dry mouth.

Puberty/Menstruation

During puberty, a young women’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

Because these contain either progesterone or estrogen, they may mimic pregnant dental symptoms such as bleeding, swollen and sore gums. Women using oral contraceptives have a much great chance of developing a painful condition know as “dry socket” after an extraction. This is a situation where the blood clot does not form properly after an extraction resulting in a localized, painful inflammation. Be sure to inform you dentist if you are using oral contraceptives and having a tooth extracted.

Pregnancy

It is common for pregnant women to experience bleeding, swollen and painful gums; another condition that may also develop is 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.

Menopause

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.

Medication

Diet pills, antihistamines, some blood pressure drugs, antidepressants and certain other medications 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.