更年期女性における口腔の変化-総説的考察-

Changes in the Oral Cavity in Menopausal Women-A Narrative Review.

抄録

更年期における口腔の健康意識は、ホルモンの変化により起こりうる不可避な不都合を最小限に抑えるために不可欠である。エストロゲンホルモン濃度の低下は、膣粘膜と同様に口腔粘膜にも影響を及ぼす。エストロゲンの欠乏は、口腔粘膜上皮の成熟過程にも影響を及ぼし、粘膜上皮の菲薄化や萎縮を招き、局所的な機械的損傷を受けやすくなり、疼痛耐性の変化や取り外し可能な補綴物の使用に問題が生じる。更年期の粘膜上皮は、感染症、口腔灼熱症候群、口腔扁平苔癬（OLP）、特発性神経障害などに罹患しやすくなる。さらに、唾液腺もホルモンに依存しているため、唾液の分泌量や粘度が変化する。その結果、唾液は歯や歯周組織に影響を及ぼし、更年期女性におけるう蝕や歯周病のリスクを高めることになる。更年期女性には、口腔内に様々な愁訴や症状が現れるため、この時期に医師や歯科医師から特別な予防・治療ケアを受けるべき重要な患者群となる。

Oral health awareness during the menopausal period is essential to minimize the inevitable inconveniences which may occur due to hormonal changes. The decrease in estrogen hormone concentration impacts the oral mucosa in a similar way to the vaginal mucosa due to the presence of estrogen receptors in both of these structures. An estrogen deficiency also affects the maturation process of the oral mucosal epithelium and can lead to its thinning and atrophy, making it more susceptible to local mechanical injuries, causing a change in pain tolerance and problems in the use of removable prosthetic restorations. Mucosal epithelium during the menopausal period is more vulnerable to infections, , burning mouth syndrome, oral lichen planus (OLP), or idiopathic neuropathy. Moreover, salivary glands are also hormone-dependent which leads to changes in saliva secretion and its consistency. In consequence, it may affect teeth and periodontal tissues, resulting in an increased risk of caries and periodontal disease in menopausal women. Due to the large variety of complaints and symptoms occurring in the oral cavity, menopausal women constitute a significant group of patients who should receive special preventive and therapeutic care from doctors and dentists in this particular period.