Dental Tribune USA

Women at higher risk for cavities

By University of Oregon
October 14, 2008

Reproduction pressures and rising fertility explain why women suffered a more rapid decline in dental health than did men as humans transitioned from hunter-and-gatherers to farmers and more sedentary pursuits, says a University of Oregon anthropologist. The conclusion follows a comprehensive review of records of the frequencies of dental cavities in both prehistoric and living human populations from research done around the world. A driving factor was dramatic changes in female-specific hormones, reports John R. Lukacs, a professor of anthropology who specializes in dental, skeletal and nutritional issues.

Reproduction pressures and rising fertility explain why women suffered a more rapid decline in dental health than did men as humans transitioned from hunter-and-gatherers to farmers and more sedentary pursuits, says a University of Oregon anthropologist. The conclusion follows a comprehensive review of records of the frequencies of dental cavities in both prehistoric and living human populations from research done around the world. A driving factor was dramatic changes in female-specific hormones, reports John R. Lukacs, a professor of anthropology who specializes in dental, skeletal and nutritional issues.

The study examined the frequency of dental caries by sex to show that women typically experience poorer dental health than men. Among research reviewed were studies previously done by Lukacs. Two clinical dental studies published this year (one done in the Philippines, the other in Guatemala) and cited in the paper, Lukacs said, point to the same conclusions and “may provide the mechanism through which the biological differences are mediated.”

A change in food production by agrarian societies has been associated with an increase in cavities. Anthropologists have attributed men/women differences to behavioural factors, including a sexual division of labor and dietary preferences. However, Lukacs said, clinical and epidemiological literature from varied ecological and cultural settings reveals a clear picture of the impacts on women’s oral health.

“The role of female-specific factors has been denied by anthropologists, yet they attain considerable importance in the model proposed here, because the adoption of agriculture is associated with increased sedentism and fertility,” Lukacs said. “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. The combined impacts of increased fertility, dietary changes and division of labour during the move into agricultural societies contributed to the widespread gender differential observed in dental caries rates today.”

Lukacs’ meta-analysis looked at both prehistoric anthropological and modern health records. He repeatedly found that increases in cavities go in favour of women in adulthood. Lukacs’ review found that women’s higher rates of cavities are influenced by female sex hormones, the biochemical composition and flow rate of saliva, as well as food cravings, immune response and aversions during pregnancy.

How the factors combine to contribute to higher risk of cavities in women as they age is not fully documented or understood, he wrote. “However, if hormonal and physiological factors work in an independent or additive manner, their impact on women’s oral health could be significant. 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.”

(Edited by Daniel Zimmermann)

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