The Sex and Gender Intersection in Chronic Periodontitis

Abstract

Periodontitis, a complex polymicrobial inflammatory disease, is a public health burden affecting more than 100 million people and being partially responsible for tooth loss. Interestingly, periodontitis has a documented higher prevalence in men as compared to women signifying a possible sex/gender entanglement in the disease pathogenesis. Although relevant evidence has treated sex/gender in a simplistic dichotomous manner, periodontitis may represent a complex inflammatory disease model, in which sex biology may interfere with gender social and behavioral constructs affecting disease clinical phenotype. Even when it became clear that experimental oral health research needed to incorporate gender (and/or sex) framework in the hypothesis, researchers overwhelmingly ignored it unless the research question was directly related to reproductive system or sex-specific cancer. With the recognition of gender medicine as an independent field of research, this study challenged the current notion regarding sex/gender roles in periodontal disease. We aimed to develop the methodological and analytical framework with the recognition of sex/gender as important determinants of disease pathogenesis that require special attention. First, we aim to present relevant sex biologic evidence to understand the plausibility of the epidemiologic data. In periodontitis pathogenesis, sex dimorphism has been implicated in the disease etiology possibly affecting the bacterial component and the host immune response both in the innate and adaptive levels. With the clear distinction between sex and gender, gender oral health disparities have been explained by socioeconomic factors, cultural attitudes as well as access to preventive and regular care. Economic inequality and hardship for women have resulted in limited access to oral care. As a result, gender emerged as a complex socioeconomic and behavioral factor influencing oral health outcomes. Taken together, as disease phenotypic presentation is a multifactorial product of biology, behavior and the environment, sex dimorphism in immunity as well as gender socio-behavioral construct might play a role in the above model. Therefore, this paper will provide the conceptual framework and principles intergrading sex and gender within periodontal research in a complex biologic and socio-behavioral dimension.

Detection of Aggregatibacter actinomycetemcomitans and red complex bacteria from supragingival and subgingival plaque samples of healthy individuals before orthodontic treatment - A clinical and microbiological correlation

“…In the present study, Pg was seen in higher concentration in females when compared to males which is in consensus to the review findings of Effie. [26] The author suggested that the microbial gender variations observed were mainly based on innate immune response of individuals and suggested that the host microbial hypothesis in the pathogenesis of periodontal diseases between males and females needs further evaluation. However, in the present study, we definitely found some difference in the prevalence of the selected microorganisms between males and females.…”

Efektivitas Tindakan Skeling terhadap Perawatan Gingivitis di Rumah Sakit Gigi dan Mulut Universitas Sam Ratulangi Manado

“…Penelitian ini menunjukkan dua hari pasca skeling didapatkan penurunan skor MGI yang berarti skeling efektif dalam penyembuhan gingivitis walaupun pada responden berjenis kelamin perempuan penyembuhan gingivitis memakan waktu lebih lama karena kesehatan jaringan periodontal pada perempuan dipengaruhi oleh fluktuasi hormon estrogen dan progesteron yang dapat berpengaruh pada proses pemulihan gingiva pasca skeling. 18,19 Pada penelitian ini gingivitis sebelum skeling yang paling banyak muncul terjadi pada usia 17-25 tahun sebanyak 18 orang dengan gingivitis sedang sebanyak 12 orang (66,6%) (Gambar 5). Hal ini terjadi karena usia remaja akhir cenderung mengonsumsi makanan rendah vitamin C dan rendah kalsium, namun tinggi konsumsi minuman berkarbonasi, sehingga responden berusia 17-25 tahun banyak yang menderita defisiensi vitamin C dan kalsium yang akan memengaruhi kesehatan jaringan periodontalnya.…”

Pathomorphological changes in the periodontal complex tissues in the period of experimental bacterial-immune periodontitis chronization

“…The manifestation and progression of the periodontitis signs depends on many reasons, including presence of somatic diseases, social, behavioral, systemic, genetic factors, microbial plaque and other risk factors [5,6]. Among chronic periodontal diseases, generalized chronic periodontitis is in the first place [7]. The factors that induce prolonged inflammation and periodontal tissues destruction usually include exo-and endotoxins of parodontopathogenic bacteria.…”