WOMEN HAVE MORE CARIES THAN MEN

[dentistet]

Women experienced a more rapid decline in dental health than did men as humans made the transition from hunting and gathering to farming and more sedentary pursuits, according to an article in the October issue of Current Anthropology.

John R. Lukacs, PhD, a professor of anthropology at the University of Oregon, who specializes in dental, skeletal and nutritional issues, examined the frequency of dental caries by sex to show that women typically have experienced poorer dental health than have men. In his meta-analysis, which looked at both prehistoric anthropological and modern health records from around the world, he repeatedly found that increases in caries were in adult women.

"I argue that the rise of agriculture increased demands on women's reproductive systems, contributing to an increase in fertility that intensified the negative impact of dietary change on women's oral health," said Dr. Lukacs.

He concluded from his research that women's higher rates of caries are influenced by three main factors:

– Female sex hormones. Citing his own research published in 2006, Dr. Lukacs noted that these hormones and associated physiological factors can significantly affect cavity formation. He also cited a study of animals published in 1954 that found that female estrogens, but not male androgens, were correlated with caries rates. He suggested that there is a cumulative effect of estrogens, including fluctuations at puberty and high levels during pregnancy, that promotes caries.

– The biochemical composition and flow rate of saliva. Women produce less saliva than do men, reducing the removal of food residue from the teeth. During pregnancy, the chemical composition of saliva changes, reducing saliva's antimicrobial capacity.

– Food cravings, immune response and aversions during pregnancy. Dr. Lukacs reported that research has shown that women have an aversion to meat in the first trimester and crave high-energy, sweet foods during the third trimester.

How these factors combine to contribute to a higher risk of caries in women as they age is not fully documented or understood, wrote Dr. Lukacs. "However, if hormonal and physiological factors work in an independent or additive manner, their impact on women's oral health could be significant," he wrote. "The fact that women's caries experience increases with age at a greater rate than men's in diverse ethnic groups from different ecological and cultural settings supports this interpretation."

The Alexander von Humboldt Foundation, American Institute of Indian Studies, American Philosophical Society, L.S.B. Leakey Foundation, National Geographic Society, National Science Foundation and Wenner-Gren Foundation for Anthropological Research supported the project.

Compiled by Amy E. Lund, senior editor.


J Am Dent Assoc, Vol 140, No 1, 20-22.
© 2009 American Dental Association