Explaining sex differences in dental caries prevalence: Saliva, hormones, and "life-history" etiologies
Explaining sex differences in dental caries prevalence: Saliva, hormones, and "life-history" etiologies
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DOI：
10.1002/ajhb.20530
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发表时间：
2006-07-01
影响因子：
2.9
通讯作者：
Largaespada, Leah L.
中科院分区：
文献类型：
--
作者：
Lukacs, John R.;Largaespada, Leah L.
当按性别报告龋齿率时，通常发现女性的患病率高于男性。这一发现通常适用于具有不同生存系统的不同文化和不同的年代。例外是存在的，但并不常见。在本文中，我们介绍了加那利群岛特内里费岛（Tenerife, Canary Islands） Guanches人龋齿发病率的性别差异的新数据，总结了龋齿患病率的荟萃分析结果，并强调了强调女性激素和生活史事件在龋齿病因中的关键作用的新研究。在瓜族人中，女性校正牙数龋齿率（8.8%,158/ 1790）约为男性龋齿率（4.5%,68/ 1498）的两倍。女性患龋率较高通常可以用以下三个因素之一来解释：1)女孩长牙较早，因此女孩的牙齿暴露在致龋口腔环境中的时间较长；2)妇女更容易获得食物供应，在准备食物时经常吃零食；3)怀孕。人类学家倾向于用行为来解释，包括性别分工和妇女在食品生产中的家庭角色。相比之下，怀孕导致口腔健康状况恶化和龋齿发病率升高的因果关系却被淡化或忽视。本文介绍了在个体生活史中与激素水平波动相关的生理变化以及这些变化对女性口腔健康的影响的最新研究。在青春期、月经和怀孕等事件中，荷尔蒙的波动在几个重要方面改变了唾液的生化组成和总体唾液流速，使得女性的口腔环境比男性更容易患龋齿。这些结果表明，荷尔蒙波动会对女性的口腔健康产生巨大影响，是解释龋齿率性别差异的重要原因。
When dental caries rates are reported by sex, females are typically found to exhibit higher prevalence rates than males. This finding is generally true for diverse cultures with different subsistence systems and for a wide range of chronological periods. Exceptions exist, but are not common. In this paper, we present new data for sex differences in dental caries rates among the Guanches (Tenerife, Canary Islands), summarize results of meta-analyses of dental caries prevalence, and emphasize new research that stresses the critical role of female hormones and life-history events in the etiology of dental caries. Among the Guanches, corrected tooth-count caries rates for females (8.8%, 158/1,790) are approximately twice the frequency of caries among males (4.5%, 68/1,498). Higher caries prevalence among females is often explained by one of three factors: 1) earlier eruption of teeth in girls, hence longer exposure of girls' teeth to the cariogenic oral environment, 2) easier access to food supplies by women and frequent snacking during food preparation, and 3) pregnancy. Anthropologists tend to favor explanations involving behavior, including sexual division of labor and women's domestic role in food production. By contrast, the causal pathways through which pregnancy contributes to poorer oral health and higher caries rates are deemphasized or discounted. This paper presents recent research on physiological changes associated with fluctuating hormone levels during individual life histories, and the impact these changes have on the oral health of women. The biochemical composition of saliva and overall saliva flow rate are modified in several important ways by hormonal fluctuations during events such as puberty, menstruation, and pregnancy, making the oral environment significantly more cariogenic for women than for men. These results suggest that hormonal fluctuations can have a dramatic effect on the oral health of women, and constitute an important causal factor in explaining sex differences in caries rates.