Salivary Calcium in Post-menopausal Women and Prevalence of Dental Caries
Condition: Salivary Calcium
MeSH terms: Dental Caries
Study type: Observational [Patient Registry]

Summary: 
      Different phases of a woman's life are puberty, menses, pregnancy, and menopause. Menopause
      is one of the normal developmental stages in a woman's life, marks the permanent cessation of
      menstruation. It occurs due to irreversible changes in the hormones.The gradual variation and
      circulating sex hormones affect women's psychological balance and quality of life. The
      hormonal changes affect the reproductory system and affect the bone integrity and overall
      health of the individual. The only source of oocytes in women is an ovary. That is the
      primary source of oestrogens and progesterone, majorly the androgens. Therefore, various
      systemic health concerns like vasomotor symptoms, cardiovascular diseases, cancer, sexual
      problems, osteoporosis, and poor oral health
    

Detailed description: 
      The presence of estrogen receptors detected through immunohistochemistry in the oral cavity
      plays a significant role in associating the effect of post-menopausal conditions to
      variations in the oral environment like salivary hypofunction, oral discomfort, and oral
      mucosal disorders. The vaginal mucosa and oral mucosa are similar histologically due to
      stratified squamous epithelium and desquamative growth pattern. Therefore, the variation in
      hormonal status in post-menopausal women may lead to the proliferation and maturation of oral
      epithelium in response to circulating estrogens. The keratinocytes and fibroblasts in the
      gingival tissues are majorly targeted by estrogen leading to periodontitis, fibroblastic
      hyperplasia, and desquamatic lesions. Therefore, it is a proven fact that gingiva is a
      traditional estrogen target, leading to the destruction of supporting structures of a tooth,
      causing periodontitis and thereby exposing tooth structure. Another primary oral
      manifestation in menopausal women is xerostomia/dryness of the mouth. The salivary components
      provide defense by maintaining the desired pH and decreasing the prevalence of caries, but
      estrogen levels directly decrease the salivary flow rate. Thus, the prevalent acidic pH
      causes demineralization and destruction of enamel, dentin making it more susceptible to
      dental caries.

      A correlation between bone mineral density, salivary calcium levels, and estrogen levels is
      already established. Hence, the salivary calcium levels can indicate increased
      demineralization of tooth surface and osteoporosis in menopausal. Hence, the present focuses
      on estimating salivary calcium levels and their association with the prevalence of dental
      caries in post-menopausal women.
    

Intervention name(s): Saliva
Intervention type(s): Other
Intervention description(s): Unstimulated whole saliva is collected
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The study was conducted among 40 post-menopausal women and 40 premenopausal women reporting
        to the OPD department of conservative dentistry and endodontics for a regular dental
        checkup. Individuals with metabolic disorders were and under supplementation were excluded.
        Women under the age group of 50 - 70 Y were included. Informed consent was obtained, DMFT
        index was recorded, and unstimulated salivary samples were collected with tarson's
        collection tubes. Individuals in the case group were further divided into three groups
        based on their caries experience into group 1: DMFT (D=1); group 2: DMFT(D=2-10), group 3:
        DMFT <10). The control group included individuals with no caries experience (D=0) and
        individuals who have not attained their menopause
      
Keywords: pre-menopausal; Post-menopausal; salivary calcium; dental caries