Kidneys play a critical role in overall health by removing waste products from the blood. When they fail to sufficiently filter out foreign elements, several serious, lifethreatening, medical conditions can result. A new study suggests that chronic kidney disease may also be linked with tooth loss. Results of the survey are published online today in Menopause, the journal of The Menopause Society.
A woman’s glomerular filtration rate shows how well her kidneys are functioning. Kidney function decreases with time after menopause and is associated with declining reproductive hormone levels. These hormone changes during menopause also often lead to abdominal obesity, which is an independent risk factor for the development of chronic kidney disease and also linked with a higher risk of tooth loss.
The consequences of kidney disease are numerous, including an increased probability of experiencing problems with bone and cardiovascular health. Tooth loss, which reflects oral health status, is also associated with systemic diseases, such as diabetes, thyroid disease, and osteoporosis, and is independently associated with an increased risk of stroke. Excessive tooth loss can also impair chewing and speech.
Previous studies have identified an association between kidney function and tooth count. This newest study involving nearly 65,000 participants, however, is the first known to evaluate the association between chronic kidney disease and tooth loss in postmenopausal women across the ages. It concluded that the glomerular filtration rate, a measure of kidney function, is significantly associated with having at least 20 (of a total of 28) adult teeth, suggesting that chronic kidney disease and tooth loss are significantly associated, especially in postmenopausal women aged 66 to 79 years.
These findings suggest that preventing and managing mineral and bone metabolism disorders in postmenopausal women with chronic kidney disease are crucial to prevent tooth loss. It is also important to address kidney disease progression, as the consequences affect multiple body systems beyond just oral health.
Survey results are published in the article “Chronic kidney disease in postmenopausal women is associated with tooth loss.”
“This study highlights the known link between chronic kidney disease and bone metabolism. Increased attention to oral and bone health is warranted in postmenopausal women with chronic kidney disease, in addition to meticulous efforts aimed at preserving kidney function. Conversely, oral health is a window to overall health, and good oral hygiene is important for women of all ages,” says Dr. Stephanie Faubion, medical director for The Menopause Society.
The hidden challenges faced by people with tooth loss and dentures has been identified by new research from the University of Sheffield.
Improvements in dental care, more people living longer and the social value placed on having a healthy smile has led to people keeping their own teeth longer, but it has also led to an increasing number of people needing some kind of restoration work including crowns, bridges and implants.
Many of these treatments remain unobtainable for most people due to the availability of NHS dentists and the high cost of private dental work. Removable dentures are often the only viable option for anyone experiencing tooth loss with an estimated 10 to 15 percent of the population wearing them.
A new study by researchers at the University of Sheffield’s Healthy Life Span Institute and the School of Clinical Dentistry has highlighted the emotional struggles and hidden challenges patients experience when having dentures fitted. This is the first study to map out the patient journey and how this experience can affect the overall success of the treatment.
The study found that patients think about their denture journey in four stages:
Tooth Loss: This is the initial stage where patients experience the physical loss of teeth.
The Emotional Tunnel: This stage focuses on the emotional rollercoaster of tooth loss. Patients experience self-consciousness, depression, and struggle with dentures. They may feel shame, anger, or fear, but also hope.
Prosthetic Hope: This stage represents the hope and optimism patients feel when getting dentures. They might anticipate regaining their smile and ability to eat normally.
Prosthetic Compromise leading to managing disclosure: This final stage acknowledges that dentures take some getting used to. Patients might need to adjust their expectations and learn how to manage talking and eating with dentures. They might also develop strategies to feel comfortable disclosing their denture use to others.
These feelings and how dentists understand and manage them can influence the patient outcomes. A dentist's empathy during this adjustment period is crucial for successful denture use and better patient outcomes.
The study also identified that wearing removable dentures can be a hidden disability for many. People with dentures feel they have to hide them due to feeling embarrassed or worrying they will fall out. Some patients also avoided social situations
Lead researcher Barry Gibson, Professor in Medical Sociology at the University of Sheffield said “Tooth loss can be hugely traumatic and this study has uncovered just how challenging it is for people needing partial dentures. Feelings such as embarrassment or shame can significantly affect the process of having dentures made and fitted. On top of this if they don’t fit properly this can make everyday activities such as speaking, eating and drinking very difficult which affects a person’s quality of life. The impact can be so dramatic that it can impact their confidence to leave the house. This can have a devastating and lasting impact.
“Understanding the emotional difficulties identified in the study will help dentists to improve the care given to denture patients and lead to a more successful and better experience for everyone”
The research team partnered with local Sheffield artist Gina Allen to create an art piece reflecting the diverse emotional journeys of denture wearers.
The picture is a collage that illustrates the type of journeys patients go through from tooth loss to life with a denture. It uses colour to depict the emotional nature of the journey and demonstrates that all patients have a unique journey and outcome from the experience. One patient, a young woman, has a successful outcome; a middle-aged man is OK but a bit 'Meh!' An older woman continues to struggle to cope with some aspects of adapting to her denture.
Artist Gina Allen said “I’m a visual artist with a science background and a particular interest in how art can help to explore and interpret data, often around social and environmental themes. It seemed to me that there was such a depth and variety of individual experiences captured by the research team on this project, so it was a really interesting challenge to be involved in, trying to use the visual parameters of an artwork to convey some of that in an engaging and meaningful way.”
This collaboration has influenced the development of a new patient questionnaire designed to:
Identify Individual Needs: Tailor care based on specific patient experiences.
Improve Communication: Enable dentists and patients to have open conversations about dentures.
Trigger Follow-Up: Identify patients who may need additional support.
In addition to identifying the emotional challenges faced by patients, the study also highlights the need for a clinical care pathway to improve patient support, focus on improving denture fit, educate patients about denture care, and combat the shame and stigma associated with wearing dentures.
Mr Bilal El-Dhuwaib, Clinical Teacher in Restorative Dentistry at the University of Sheffield,said: “This study is important because it goes beyond the typical numbers-driven approach to dentistry by looking at crucial aspects of patients' emotions and lived experiences. By understanding the psychological and social impact of tooth loss and replacement, the research provides a valuable toolkit for myself and fellow dentists to better understand and address the emotional rollercoaster patients navigate during this process. By equipping dentists with the tools to understand these challenges, we can create a more compassionate and effective approach to tooth replacement."
Researchers have identified a significant change in composition and abundance of bacteria in study participants’ oral microbiomes after using a popular brand of alcohol-based mouthwash.
The oral microbiome is the community of bacteria that live in the mouth, they help us digest our food and keep our mouth healthy.
Researchers found that two species of opportunistic bacteria were significantly more abundant in the mouth after daily use of the alcohol-based mouthwash, Fusobacterium nucleatum and Streptococcus anginosus.
These two bacteria have been previously linked to several diseases including gum disease and oesophageal and colorectal cancers.
Although results show potentially damaging alterations to the microbiome, researchers urge that the study results do not mean that the general public should no longer use mouthwash.
The oral microbiome is the community of bacteria that live in the mouth, they help us digest our food and keep our mouth healthy. Changes to the composition of the oral microbiome have been linked to periodontal diseases and some cancers.
The research, published in Journal of Medical Microbiology found that two species of opportunistic bacteria were significantly more abundant in the mouth after three months of daily use of the alcohol-based mouthwash, Fusobacterium nucleatum and Streptococcus anginosus. These two bacteria have been previously linked to gum disease, esophageal and colorectal cancers. Researchers also saw a decrease in a group of bacteria called Actinobacteria which are crucial contributors to the regulation of blood pressure.
Dr Jolein Laumen, first author of the study and researcher at ITM’s Unit of Sexually Transmitted Infections said:
“Alcohol-based mouthwashes are widely available. The public may use them daily to tackle bad breath or prevent periodontitis, but they should be aware of the potential implications. Ideally, long-term usage should be guided by healthcare professionals”.
