Paganini-Hill A
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, California, USA.
Compend Contin Educ Dent Suppl. 1998(22):S4-8.
Tooth loss and alveolar residual ridge resorption are significant oral health problems in older adults. Although the causes of tooth loss are many, several studies show an association between tooth loss/residual resorption and systemic osteoporosis. Because estrogen replacement therapy (ERT) slows the development of osteoporosis, we investigated the relationship between estrogen use and tooth loss among elderly women who were participating in the Leisure World Cohort Study. Among 3,921 women 52 to 109 years old (median = 81), those who had ever used estrogen retained more teeth than nonusers (21.2 vs 19.2). The age-adjusted risk of having fewer than 25 teeth decreased with increasing duration of ERT: 0.87 for < 4 years of ERT, 0.74 for 4 to 14 years, and 0.70 for 15+ years compared to nonusers. Similarly, the risk of edentia was inversely related to estrogen use. If a woman had ever taken ERT, her risk of losing all her teeth was about two thirds that of a woman who had never used estrogen. Long-term users (15+ years) had half the risk of becoming toothless. Despite differences in age, education, methods of obtaining tooth and hormone data, and prevalence of tooth loss, two other cohort studies (the Nurses' Health Study and the Framingham Heart Study) reported similar reductions in tooth loss among estrogen users. The data suggest that tooth retention, in addition to being affected by osteoporosis of alveolar bone, also shares in the benefits of ERT on osteoporosis.
牙齿缺失和牙槽嵴残余吸收是老年人重要的口腔健康问题。尽管牙齿缺失的原因众多，但多项研究表明牙齿缺失/残余吸收与全身性骨质疏松之间存在关联。由于雌激素替代疗法（ERT）可减缓骨质疏松的发展，我们对参与休闲世界队列研究的老年女性中雌激素使用与牙齿缺失之间的关系进行了调查。在3921名年龄在52至109岁（中位数 = 81岁）的女性中，曾经使用过雌激素的女性保留的牙齿比未使用者更多（21.2颗对19.2颗）。随着ERT使用时间的增加，牙齿少于25颗的年龄调整风险降低：ERT使用时间<4年的为0.87，4至14年的为0.74，15年及以上的为0.70，与未使用者相比。同样，无牙风险与雌激素使用呈负相关。如果一名女性曾经接受过ERT，她失去所有牙齿的风险约为从未使用过雌激素的女性的三分之二。长期使用者（15年及以上）无牙的风险减半。尽管在年龄、教育程度、获取牙齿和激素数据的方法以及牙齿缺失患病率方面存在差异，但另外两项队列研究（护士健康研究和弗雷明汉心脏研究）报告称，雌激素使用者的牙齿缺失也有类似程度的减少。数据表明，牙齿保留除了受牙槽骨骨质疏松的影响外，还得益于ERT对骨质疏松的益处。
