Effect of menopause on salivary glands and oral mucosa

Abstract

StreszczenieChęć zachowania naturalnego i zdrowego uzębienia przez całe życie człowieka wiąże się z regularnymi wizytami kontrolnymi w gabinecie stomatologicznym oraz poddawaniem się wymaganym procedurom leczniczym. W społeczeństwie rośnie świadomość potrzeby utrzymania zdrowia jamy ustnej, dlatego lekarze stomatolodzy obejmują swoją opieką pacjentów w każdym wieku. Wśród nich liczną grupę stanowią kobiety w wieku około-i pomenopauzalnym. Ze względu na wygaśnięcie wewnątrzwydzielniczej funkcji jajników dochodzi u nich do zmniejszenia stężenia hormonów estrogenowych. Prowadzi to do szeregu implikacji ogólnoustrojowych, włą-czając negatywny wpływ na ślinianki oraz błonę śluzową jamy ustnej. U pacjentek tych lekarze stomatolodzy muszą brać pod rozwagę fakt, że mogą one cierpieć na schorzenia jamy ustnej specyficzne dla tego okresu życia. W niniejszej pracy przedstawiono najczęściej pojawiające się dolegliwości dotyczące jamy ustnej kobiet w wieku około-i pomenopauzalnym. Podczas gdy pojawiające się w przebiegu menopauzy objawy ogólne są powszechnie znane, ciągle niska jest świadomość, że dyskomfort w obrębie jamy ustnej jest również częścią dolegliwości tego okresu. Autorzy przedstawiają aktualny stan wiedzy dotyczący wpływu niedoboru estrogenów oraz ich suplementacji na ślinianki oraz błonę śluzową jamy ustnej u kobiet w wieku około-i pomenopauzalnym. Szczególną uwagę zwrócono na objawy związane z nieprawidłowym nawilżeniem błony śluzowej jak również pojawiającym się najczęściej w tym wieku zespołem piekących ust. Autorzy przedstawili także metody terapii wymienionych dolegliwości.Słowa kluczowe: niedostateczne wydzielanie śliny, zespół piekących ust, menopauza. SummaryPreserving natural and healthy dentition till the end of life is strongly connected with regular control visits at the dentist's surgery and following therapeutic procedures that may be found necessary. Today's society develops an awareness of the necessity to preserve good health of the oral cavity. Therefore, dentists attempt to provide medical care to the patients of all ages, including menopausal women. Women at the perimenopausal or post-menopausal age often experience a decrease in estrogenic hormone concentration due to discontinued endocrinological activity of the ovaries. This leads to a number of systemic implications, including the negative effect on salivary glands and oral mucosa. It is important to keep in mind that such patients may suffer from oral diseases specific to their age. This paper presents most common oral diseases that occur in women at the menopausal or perimenopausal age. While the systemic aspects of menopause are well documented, the awareness of oral discomfort as a part of menopausal complaints is still low. The authors present the current state of knowledge on how deficiency or supplementation of estrogens can affect salivary glands and oral mucosa in perimenopausal and post-menopausal women. Particular attention is paid to symptoms resulting from abnormal lubrication of oral mucosa or burning mouth syndrome, the la...

Selected Physicochemical Properties of Saliva in Menopausal Women—A Pilot Study

“…Oral dryness is one of the most common oral symptoms reported by menopausal women. The prevalence and severity of symptoms may not be proportional to the amount of saliva secreted; however, multiple studies indicate the presence of estrogen receptors in the salivary glands, whose activity can possibly be affected in menopause due to decreased level of estrogen during this time [2,[5][6][7][8]. In our studies of menopausal women, a decrease in salivary flow rate in comparison to premenopausal women was observed.…”

“…To the best of our knowledge, the oral mucosa, like the vaginal mucosa, contains estrogen receptors. They also occur in the salivary glands [2,[5][6][7][8]. Therefore changes in estrogenic hormone levels may have a direct impact on the oral cavity in terms of effects within both the oral mucosa itself and its microflora, as well as the amount of saliva secreted by the salivary glands, and as a consequence may adversely affect teeth and periodontal tissues, resulting in an increased risk of caries and periodontal disease.…”

“…Therefore changes in estrogenic hormone levels may have a direct impact on the oral cavity in terms of effects within both the oral mucosa itself and its microflora, as well as the amount of saliva secreted by the salivary glands, and as a consequence may adversely affect teeth and periodontal tissues, resulting in an increased risk of caries and periodontal disease. Estrogen deficiency also affects the maturation process of the oral mucosal epithelium and can lead to its thinning and atrophy, making it more susceptible to local mechanical injuries and causing a change in pain tolerance and problems in the use of removable prosthetic restorations [2][3][4][5][6]. Because of atrophic changes in the oral mucosa, menopausal women can often develop a series of persistent diseases, like burning mouth syndrome, lichen Wilsoni, idiopathic neuropathy, and increased tendency to develop candidiasis due to increased colonization of microorganisms in patients with reduced salivation [4].…”

“…Because of atrophic changes in the oral mucosa, menopausal women can often develop a series of persistent diseases, like burning mouth syndrome, lichen Wilsoni, idiopathic neuropathy, and increased tendency to develop candidiasis due to increased colonization of microorganisms in patients with reduced salivation [4]. Moreover, during the menopausal period, not only the amount of secreted saliva, but also its compositionmay change [5,9]. Individual elements occurring in saliva play a strictly defined role in the proper functioning of the whole organism, nourishing and protecting the surrounding tissues.…”

“…Moreover, many elements presenting antimicrobial activity are present in saliva, such as immunoglobulins A, lysozyme, lactoferrin, histamine, and leukocytes [10][11][12]. The occurring changes in the level of steroid hormones also reduces the intestinal absorption of calcium into the body, which in turn leads to disturbances in the regulation of calciumphosphate metabolism, resulting in increased release of calcium into both blood serum and saliva [5,13,14]. A significantly higher concentration of calcium in the saliva of menopausal women may therefore lead to a faster mineralization of plaque and, consequently, increased calculus formation, which has an undoubted effect on the progression of gingivitis and periodontitis [15][16][17].…”