Women are periodontally healthier than men, but why don't they have more teeth than men?
OBJECTIVE
Periodontal diseases are more prevalent in men than in women. However, in a population-based epidemiological study, we found that, on average, women have fewer teeth than men. The aim of this study was to test different hypotheses that could explain this obvious paradox.


METHODS
In 4,290 randomly selected participants from the normal population (Study of Health in Pomerania), we determined diagnostic periodontal parameters, attachment loss, and number of teeth. Behavioral and environmental risk factors were assessed by interviews and questionnaires. Use of estrogens was assessed, and urinary excretion of collagen cross-links was determined.


RESULTS
Multiple regression analyses adjusted for caries and periodontitis revealed that in the women of this population, there is an inverse association between the number of children born and the number of teeth (P < 0.01). This relationship depends on socioeconomic status, bone metabolism, and the use of estrogens. In the group of the youngest (20-40 years), the bone turnover rate is positively related to the number of children born (P < 0.01). In postmenopausal women treated with estrogens, the number of teeth was higher than in men of the same age group. Only in women without hormone treatment were there fewer teeth.


CONCLUSIONS
The apparent paradox of having fewer teeth despite better periodontal health in women compared with men is related to an increased bone turnover rate and socioeconomic conditions such as low education and low social status. Periodontal health is even worse if these factors are combined.
Meisel
Peter
P
Department of Pharmacology, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany. meiselp@uni-greifswald.de
Reifenberger
Jenni
J
Haase
Romy
R
Nauck
Matthias
M
Bandt
Christoph
C
Kocher
Thomas
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000652:urine; D016000:Cluster Analysis; D003729:Dental Care; D003753:Dental Health Surveys; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology* / Q000503:physiopathology; D010298:Parity; D010518:Periodontitis / Q000453:epidemiology*; D011247:Pregnancy; D012737:Sex Factors; D012923:Social Class; D016388:Tooth Loss / Q000453:epidemiology*
D000596:Amino Acids; C036020:deoxypyridinoline