August 19, 2009 | Modern Hygienist

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The overlooked syndrome

A personal recommendation on the treatment of Polycystic Ovarian Syndrome.

by Tonya R. Rebhahn, RDH

Anyone who has made it through dental hygiene school—or has participated in any amount of continuing education—has heard numerous studies about treatment considerations for the diabetic patient. We have learned that the diabetic patient is immunocompromised and at a higher risk for periodontal disease. Many studies have taught us that insulin resistance and alterations in beta-cell-function are contributing factors that make the diabetic patient at higher risk for periodontal disease. But, did you know there is another disease out there that also has insulin resistance and alterations in beta-cell-function? This disease is called Polycystic Ovarian Syndrome (PCOS) and it is a lot more common than you may think. It wasn’t until I was diagnosed with it that I had even heard of the disease.

PCOS is a hormonal disorder with symptoms that can include: irregular periods, infertility, acne, obesity, excessive hair growth, skin discolorations, high cholesterol, elevated blood pressure, and small cysts on the ovaries. Symptoms seem to be exacerbated when the patient’s weight and insulin levels are not kept in check. The cause of the disorder is still unknown, but it is thought to be an underlying genetic predisposition caused by abnormalities in insulin production. In addition, PCOS patients tend to have an excess of male androgen hormones. Long-term complications are similar to type II diabetes mellitus and include: cardiovascular disease, obesity, high blood pressure, and high cholesterol. Reportedly, PCOS affects 4% to 6 % of women of reproductive age, where as type II diabetes mellitus only affects 2% to 4% of women of reproductive age.

What does this all mean?

In my search for information on this topic, I found it interesting that if you type into pubmed.com, “What are dental treatment considerations for caring for the diabetic patient?” a slew of articles will surface, but if you type in, “What are treatment considerations for caring for a patient with polycystic ovarian syndrome?” nothing exists in terms of oral health information. As a practicing hygienist, and a sufferer of PCOS, we need to be aware that this condition could be affecting many of our female patients and could be a contributing factor in how we approach the management of their periodontal care.

What can we do to help?

Since PCOS is very similar in nature to type II diabetes, in my opinion, the same treatment considerations should be taken for both disorders. As we learned in hygiene school, the worse the patient’s glycemic control is, the greater chance they have of developing periodontal problems. So in addition to educating our patients on proper oral homecare, low glycemic dietary and active lifestyle education should also be considered as an integral part of our healthcare program.

For more information email Tonya at: mikelsontonya@gmail.com