Table 1.

Studies of the relationship between estrogen and oral health

Study	Design	Population demographics	Dental outcome measure	Exposure measure	Covariates adjusted for in analysis	Results
Periodontal diseases
Pizzo et al. [20]	CS	91 PM women Caucasian (68.3 ± 1.8 years)	BOP PD CAL	HT+ HT–		Decreased BOP HT+ 34.8 % HT– 65.2 % (P = 0.0007) No significant differences with HT+/HT– use and PD, CAL
Haas et al. [23]	CS	328 PM women Caucasian (40–69 years)	CAL	HT+ HT–	Age, smoking, SES, dental care	Prevalence of individuals with ≥30 % 5 mm CAL: HT+ 46.3 % HT– 64.0 % Odds of having ≥30 % 5 mm CAL among HT– women OR 2.1; 95 % CI: 1.1–4.0
Evio et al. [25]	LS– 2 years	60 PM women Finnish (65–80 years)	BOP PD CPITN	(1)HT (2) Bis (3) HT+ Bis		No significant differences with HT use and BOP, PD, CPITN
Lopez-Marcos et al. [24]	LS– 1 year	210 PM women Caucasian Brazilian (40–58 years)	PD, Mobility, Recession	HT+ HT–		Changes from baseline to 12 months HT+ decreased PD HT– increased PD (P = 0.004) No significant differences with HT+/HT– use gingival recession
Ronderos et al. [22]	CS	11,665 women Representative sample (40–70 years)	CAL	HT+ HT–	Age, SES, race/ethnicity, smoking, dental care calculus	Mean CAL associated with HT+ use (SD) Never 1.74 mm (0.029) 1 year or less 1.70 mm (0.059) 2–5 years 1.55 mm (0.073) >5 years 1.56 mm (0.062) (P < 0.05)
Reinhardt et al. [19]	LS– 2 years	59 PM women Caucasian (45–60 years)	CAL Gingival inflammation	E+ sufficient E– deficient	Smoking	Gingival inflammation: E+ women 24.4 % E– women 43.8 % (P < 0.04) No significant differences between E+/E– status and CAL
Grossi [21]	CS	236 PM women Caucasian (50–75 years)	CAL ABH	HT+ HT–	Age	Mean CAL: HT+ 2.1 mm HT– 2.4 mm ABH Loss >3 mm: HT+ 34.0 % HT– 20.0 %
Alveolar bone
Payne et al. [26]	LS– 1 year	24 PM women Caucasian (40–65 years)	ABD	E+ sufficient E– deficient		Change in alveolar bone density E+ women 0.30 ± 0.07 E– women 0.44 ± 0.07 (P = 0.0001)
Civitelli et al. [27]	LS– 3 years	135 PM women Primarily Caucasian (41–70 years)	ABD ABH	HT+ Placebo	Age, BMI, smoking, years since menopause, parity	Change in alveolar bone density HT+ 1.84 % Placebo +0.95 % (P = 0.04) No significant differences between HT/placebo groups for ABD
Tooth loss
Taguchi et al. [34]	CS	330 PM women Japanese (58.8, ±7.9 years)	Tooth loss ABH	HT+ HT–	Age, years since menopause, BMI, history of hysterectomy or oophorectomy	Mean # of teeth HT+ 23.2 ± 0.9 HT– 21.9 ± 0.4 (P = 0.19) No significant differences with HT/HT– use and ABH
Krall [30]	LS– 7 years	488 PM women Caucasian (75–95 years)	Tooth loss	HT+ HT–	Age, smoking, education	Mean # of teeth HT+ 12.5 ± 0.8 HT– 10.7 ± 0.8 (P = 0.04) HT use >8 years: 3.6 more teeth
Grodstein et al. [28]	CS	42,171 women Unspecified race/ethnicity (46–55 years)	Tooth loss	HT+ HT–	Age, SES, smoking, dental care	HT duration associated with decreased risk of loss of ≥1 teeth 1 year RR: 0.78; 95 % CI; 0.67–0.94 15+ years RR: 0.73; 95 % CI; 0.65–0.83
Paganini-Hill [31]	LS– 11 years	3921 women Primarily Caucasian (52–109 years)	Tooth count	HT+ HT–	Age, smoking, alcohol, education	Decreased risk of edentia with HT+ use RR 0.64; 95 % CI; 0.51–0.79

Estrogen-sufficient E₂+, >40 pg 17 β estradiol/ml serum

Estrogen-deficient E₂–, <30 pg 17 β estradiol/ml serum

CS cross-sectional, LS longitudinal study, PM postmenopausal, BOP bleeding on probing, PD pocket depth, CAL clinical attachment loss, CPITN community periodontal index of treatment needs, Mm millimeters, SD standard deviation, ABH alveolar bone height, ABD alveolar bone density, HT+ hormone therapy supplements usually consisting of estrogen or estrogen plus a progestin, HT– no therapy, Bis bisphosphonate, BMI body mass index, SES socio-economic status, NS no significant association