EDITOR - The issue of Hormone Replacement Therapy (HRT) has recently
become a very important but somewhat controversial issue in developed
societies. As the recent article by Minelli et al.(1) highlights there are
several associated benefits and harms which in the long term can lead to
changes in the quality of life of women on HRT. A benefit not mentioned in
the article however is the influence of HRT on periodontal disease.
It has been shown that postcranial and oral bone mass are increased
in postmenopausal women receiving HRT and this improvement in oral bone
health constitutes an additional benefit of HRT(2). This can be extended
further to say that postmenopausal HRT protects against tooth loss and
reduces the risk of edentulism(3) and thus the requirement for dentures at
a later stage in life.
Tooth loss and alveolar residual ridge resorption are significant
oral health problems in older adults, having adverse psychological
effects. Oral health is vitally important to total health and overall
quality of life. Retaining natural teeth improves the quality of life by
maintaining the ability to chew and digest food, and improving the ability
to interact and socialise with peers. For example, a reduced number of
remaining teeth is associated with decreased physical activity in elderly
persons(4). People wearing dentures report lower health-related quality of
life than dentate people(5). Overall systemic health is intimately related
to oral health and quality of life. This added perspective may have been
an interesting addition to the study.
REFERENCES:
1. Minelli C, Abrams KR, Sutton AJ, Cooper NJ. Benefits and harms
associated with hormone replacement therapy: clinical decision analysis.
BMJ 2004;328:371-5.
2. Civitelli R, Pilgram TK, Dotson M, Muckerman J, Lewandowski N,
Armamento-Villareal R, Yokoyama-Crothers N, Kardaris EE, Hauser J, Cohen
S, Hildebolt CF. Alveolar and postcranial bone density in postmenopausal
women receiving hormone/estrogen replacement therapy: a randomized, double
-blind, placebo-controlled trial. Arch Intern Med 2002;162:1409-15.
4. Tada A, Watanabe T, Yokoe H, Hanada N, Tanzawa H. Relationship
between the number of remaining teeth and physical activity in community-
dwelling elderly. Arch Gerontol Geriatr 2003;37:109-17.
5. Allen PF, McMillan AS. A longitudinal study of quality of life
outcomes in older adults requesting implant prostheses and complete
removable dentures. Clin Oral Implants Res 2003;14:173-9.
Competing interests:
None declared
Competing interests:
No competing interests
22 February 2004
Gregory S. Antonarakis
Dental Student
University of Wales College of Medicine, Dental School, Heath Park, CF14 4XN
Rapid Response:
HRT and Periodontal Disease
EDITOR - The issue of Hormone Replacement Therapy (HRT) has recently
become a very important but somewhat controversial issue in developed
societies. As the recent article by Minelli et al.(1) highlights there are
several associated benefits and harms which in the long term can lead to
changes in the quality of life of women on HRT. A benefit not mentioned in
the article however is the influence of HRT on periodontal disease.
It has been shown that postcranial and oral bone mass are increased
in postmenopausal women receiving HRT and this improvement in oral bone
health constitutes an additional benefit of HRT(2). This can be extended
further to say that postmenopausal HRT protects against tooth loss and
reduces the risk of edentulism(3) and thus the requirement for dentures at
a later stage in life.
Tooth loss and alveolar residual ridge resorption are significant
oral health problems in older adults, having adverse psychological
effects. Oral health is vitally important to total health and overall
quality of life. Retaining natural teeth improves the quality of life by
maintaining the ability to chew and digest food, and improving the ability
to interact and socialise with peers. For example, a reduced number of
remaining teeth is associated with decreased physical activity in elderly
persons(4). People wearing dentures report lower health-related quality of
life than dentate people(5). Overall systemic health is intimately related
to oral health and quality of life. This added perspective may have been
an interesting addition to the study.
REFERENCES:
1. Minelli C, Abrams KR, Sutton AJ, Cooper NJ. Benefits and harms
associated with hormone replacement therapy: clinical decision analysis.
BMJ 2004;328:371-5.
2. Civitelli R, Pilgram TK, Dotson M, Muckerman J, Lewandowski N,
Armamento-Villareal R, Yokoyama-Crothers N, Kardaris EE, Hauser J, Cohen
S, Hildebolt CF. Alveolar and postcranial bone density in postmenopausal
women receiving hormone/estrogen replacement therapy: a randomized, double
-blind, placebo-controlled trial. Arch Intern Med 2002;162:1409-15.
3. Krall EA, Dawson-Hughes B, Hannan MT, Kiel DP. Postmenopausal
estrogen replacement and tooth retention. Compend Contin Educ Dent Suppl
1998;22:S17-22.
4. Tada A, Watanabe T, Yokoe H, Hanada N, Tanzawa H. Relationship
between the number of remaining teeth and physical activity in community-
dwelling elderly. Arch Gerontol Geriatr 2003;37:109-17.
5. Allen PF, McMillan AS. A longitudinal study of quality of life
outcomes in older adults requesting implant prostheses and complete
removable dentures. Clin Oral Implants Res 2003;14:173-9.
Competing interests:
None declared
Competing interests: No competing interests