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There are some dental pathologies that mainly affect females during childhood, pregnancy, and adulthood.
These pathologies involve the teeth, oral cavity, and temporomandibular joint (TMJ). Another pathology that often affects females is menopausal osteoporosis. The bone component of our body undergoes a continuous “renovation” process of building and destruction over the years. In some patients, this phenomenon is accentuated by the reduction of estrogen during menopause or during certain hormone replacement therapies.
The reason for this trend is linked to the social conditioning that sees the care and beauty of the female smile as a winning aspect for social integration. It should also be said that girls themselves demonstrate a more positive attitude towards orthodontic treatment compared to male peers, who are more attracted to body care.
Agenesia dental is the most frequent anomaly in the human race. It is the lack of development of one or more teeth in the dental arch. This phenomenon can involve both baby teeth and permanent teeth. The cause is not well known, but it is the consequence of hormonal, genetic, environmental, and infectious alterations and affects males and females equally. In females, agenesis is often bilateral and affects the upper lateral incisor and second premolar, both upper and lower.
Hypercementosis or the presence of supernumerary teeth is another common trend among Caucasian populations.
Pregnancy is a very delicate period for oral health that deserves special attention because during gestation hormonal changes can modify the composition of saliva, facilitating a greater accumulation of plaque and tartar and therefore increasing the risk of cavities and gingivitis. There is also an increased possibility of alteration of the mucous membranes of the oral cavity that become sensitized, resulting in more exposed to inflammations and infections. All these changes can be monitored and managed with a specific path of accompaniment of the oral health status of the expectant mother, which provides for the definition of a precise plan of checks by the dentist associated with advice for the maintenance of careful and correct oral hygiene.
The temporomandibular joint, or TMD, is a complex structure that allows the mandible to articulate with the skull. The opening and closing of the mouth occur when the muscles that connect the mandible to the skull and neck move. When the mandible moves, the mandibular condyle moves forward along a bony prominence in the skull. Protecting and making this movement fluid is a meniscus, and a series of ligaments hold the joint together. The teeth are the starting and ending point of the opening and closing of the mouth, and any alteration to this mechanism results in a pathological chain reaction.
TMD dysfunctions occur whenever a joint component doesn’t function properly. The mandible’s function is complex due to the mouth’s movement being controlled by two joints that must work in perfect symmetry. Even one tooth out of alignment can cause severe joint dysfunction. TMD dysfunction can affect all age groups, but statistically, the most vulnerable ages are between 30 and 50 years. Women are affected more than men due to ligament laxity.
Causes of TMD dysfunction include night grinding (bruxism), mandibular trauma, malocclusions, arthritis of the joint, craniofacial asymmetric growth, oral breathing, postural vices, anxiety, stress, and ligament laxity.
Joint pathologies are evident with difficulty opening and closing the mouth, and sometimes the mandible can get stuck in a certain position and prevent normal movements such as yawning or chewing. Clicks occur when opening and closing the mouth due to the mispositioning of the joint meniscus. Other symptoms include neck and face pain, headaches, soreness, internal pain in the ear area, dizziness, ringing, and tooth pain.
Diagnosis is made using muscle palpation, an objective examination of dentition, and through some diagnostic maneuvers. The description of signs and noises made by the patient is essential. The final diagnosis can only be made with an open and closed mouth MRI that highlights the joint structures’ condition. Appropriate exercises and the use of specific bites are used for treatment.
Avoid food in large morsels that force opening of the mouth. Food should be tender, and drinks should not contain caffeine and alcohol to avoid discharging more tension on the joint. In the acute pain phase, you can take anti-inflammatories, painkillers, and ice packs.
“What is the relationship between osteoporosis and loss of alveolar bone?” Osteoporosis is a systemic disease altering bone structure and mass that can affect various skeletal sites, including the jawbones. Some studies indicate a correlation between osteoporosis and periodontal disease with worsening of alveolar bone loss. It is recommended to have professional hygiene sessions and periodic periodontal visits for patients in menopause or those suffering from osteoporosis to monitor, prevent, or treat these phenomena.
If osteoporosis is treated with bisphosphonates orally or intravenously, inform the dentist immediately, and they will evaluate the best way to treat the dental pathology. The dentist may prescribe specific antibiotics before or after treatment as prophylaxis or therapy to avoid possible mandibular and jawbone infections.
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