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86 terms

Hormonal Imbalance

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Puberty is from ?-? yoa ovulation begins
9-16
Menses cycle: ave. ? days cycle
28
Pregnancy, oral contraceptives, and menopause (peri & post) all cause hormonal ?
imbalance
What female hormone is responsible for the cyclical changes, ? epithelium, endometrium of ?
-estrogen
-vaginal
-uterus
Estrogen levels peak at ?
ovulation
Estrogen decreases during the ? half of cycle
2nd
What female hormone is responsible for changes in endometrium of the uterus
progesterone
Progesterone is responsible for changes in ? if the uterus, ? of ? egg, and development of ? & ? glands
-endometrium
-implantation, fertilized
-placenta, mammary
Progesterone remains ? until ovulation occurs
stable
Hormonal effects on oral flora cause changes in the ? of gingival ?
-microflora
-sulcus
Hormonal effects on oral flora alter ? growing in ?
-bacteria
-plaque
Hormonal effects on oral flora can cause increased ? & ?:
-? capillaries
-regulated cellular ?
-decreased ?
-increased vascular ?
-increased production of gingival ? ?
-occurs even in the absence of what
-bleeding
-gingivitis
-dilated
-proliferation
-keratinization
-permeability
-crevicular fluid
-bacterial plaque
In hormonal effects on the oral flora you get an increase in periodontal pathogens, name the 2
-Porphyromonas gingivalis
-Actinobacillus actinomycetemcomitans
In hormonal effects on the oral flora you also see an increased on prostaglandin ?, which serves as a mediator for ?
-E
-inflammation
Hormonal effects on the oral flora also influence the ? system by ? of
-? chemotaxis
-P
-A
-?-cell response
-immune
-depression
-neutrophil
-phagocytosis
-antibodies
-T
Progesterone alters ? & ? of ? production in ?
-rate
-pattern
-collagen
-gingiva
Since progesterone alters rate & pattern of collagen production in gingiva, this results in ? ability to ? & ? structure of gingiva
-reduced
-repair
-maintain
Hormonal effects on the oral flora also cause an ? in microbes:
-Gram ? ?
-Name the 2, and say what they each do
-increase
-negative anaerobes
-Prevotella intermedia- affects blood clotting
-Capnocytophagia & P. intermedia- causes increased bleeding
In hormonal effects on the oral flora Prevotella intermedia cause what 2 things, and what is its classification
-affects bld clotting
-increases bleeding
-gram negative anaerobe
In hormonal effects on the oral flora Capnocytophagia cause what and what is its classification
-increased bleeding
-gram negative anaerobe
The male hormone testosterone is a ? hormone from the ? group
-steroid
-androgen
What is the principle male sex hormone, and where is it secreted
-testosterone
-male testes
Testosterone plays a key role in ? & ?
-20 times greater in ? than ?
-enhanced ?
-E
-? function
-protection against ?
-male & female
-male, female
-libido
-energy
-immune
-osteoporosis
What male testosterone hormones promote protein synthesis and growth of tissues with their receptors
androgens
Androgens are male testosterone hormones that promote ? ? & growth of ? with androgen ?
-protein synthesis
-tissues
-receptors
What is maturation of sex organ called
virilizing
Male testosterone hormones (androgens) have a ? effect:
-growth of ? mass & ?
-increased ? density & ?
-stimulation of ? growth & ?
-increased ? performance
-anabolic
-muscle, strength
-bone, strength
-linear, maturation
-athletic
Male testosterone hormones
*Prenatal androgen effects (7-12 weeks)
-? virilization & development of ?
-genital
-prostate
Male testosterone hormones
*Prenatal androgen effects occur when, and what 2 things happen
7-12 weeks
-genital virilization & development of prostate
Male testosterone hormones
*In early infancy (1st wks of life), ? masculinization occurs
-brain
Male testosterone hormones
*Early infancy occurs when and what occurs
1st wks of life
-brain masculinization
Male testosterone hormones
*Early postnatal effects (childhood)
-adult type body ?
-? ? of skin & hair
-appearance of ? hair
-? hair
-? spurt accelerated by ? maturation
-? upper ?, and ? hair
-odor
-increased oiliness
-pubic
-axillary
-growth, bone
-fine, lip, sideburn
In male testosterone hormones, what are these effects called, and when do they occur...
-adult type body odor
-increased oiliness of skin and hair
-appearance of pubic hair
-axillary hair
-growth spurt accelerated by bone maturation
-fine upper lip, and sideburn hair
early postnatal effects (childhood)
Male testosterone hormones
*Advanced postnatal effects (puberty)
-? enlargment, ?
-Name the 3 types of hair this person would have at this time
-What happens to their voice
-they have a growth ? (give some ex)
-What happens with their shoulders & rib cage
-phallic, libido
-pubic, face, & chest
-it deepens
-spurt (adam's apple, jaw, brow, chin, nose, etc)
-their shoulders widen, and their rib cage expands
What are the adult testosterone effects
maintence of bone density & strength
Male testosterone hormones
*Effects of testosterone on the brain
-Enlargening of what 3 body parts (there are more just give 3)
-Enzyme ? converts testosterone into ? & is responsible for ?
-? ? enzyme results in ? genders, but ? brain
-heart, lungs, liver, etc.
-aromatase, estrogen, masculinization
-reduced aromatase, male, female
In the effects of testosterone on the brain what causes male gender, but female brain
reduced aromatase enzyme
In the effects of testosterone on the brain what causes the conversion, what is converted, and it is responsible for what
-enzyme aromatase
-testosterone to estrogen
-masculinization
What else can testosterone effect regarding the brain, give details
-difference in the size of it
-males brains are typically on average larger
Since testosterone effects the difference in sizes of the brain and a male's brain is on average larger, this means, as the brain is greater in volume, it has ? ? ? ?
less interwoven brain halves
Since testosterone effects the difference in sizes of the brain and a male's brain is on average ?, this means, as the brain is ? in ?, it has ? interwoven brain ?
-larger
-greater, volume
-less, halves
In a normal brain the two sides of the brain operate together, but with the connection ?, the two halves cannot ?
-severed
-communicate
Clinical manifestations of puberty are...
-increased ?
-bacteria in the ? act to increase ?
-? response to ? irritants
-? in severity over time
-? with removal of local ?
-gingival tissue appear ?, ?-?, & ?
-gingivitis
-sulcus, bleeding
-exaggerated, minor
-decrease
-disappear, irritants
-enlarged, bluish-red, bulbous
Menstruation clinical manifestations are...
-? ? gingival tissues
-herpes ?
-? ulcers
-prolonged ? after oral ?
-swollen ? glands
-pts are generally unaware of this correlation
-erythematous swollen
-labialis
-aphthous
-bleeding, surgery
-salivary
In pregnancy there are clinical manifestations such as...
-increase ? & ? = increased ?.? bacteria
-pregnancy ?
-most evident in what months
*gingival tissue:
-bright red edema at ? & ?
-? bleeding, but decreases after what
-estrogen & progesterone = P. intermedia
-gingivitis
-2nd & 8th
-margins & papilla
-increased, after birth
If a pt is pregnant they are likely to have pregnancy gingivitis, and bc of the the increase in estrogen and progesterone they have a increase in P. intermedia bacteria. In what months is this most evident, and describe what their gingival tissues may look like, also discuss bleeding rates, and how they are affected after birth regarding bleeding
-2nd & 8th
-bright red edema at margins and papilla
-their bleeding increases, but decreases after delivery
Why may a pregnant pt have a increase in P. intermedia
b/c of the increase in estrogen & progesterone
What could a pt be affected by if their gingiva appears erythematous and swollen, they have herpes labialis, aphthous ulcers, prolonged bleeding after oral surgery, swollen salivary glands
menstruation
If a pts gingival tissues appear enlarged, bluish-red, and bulbous, what could be causing this
them going through puberty
If a pt has an exaggerated response to minor irritants, they have bacteria in their sulcus that is increasing bleeding, this will decrease in severity over time, and will disappear with removal of local irritants, what could they be going through that is causing this
puberty
A pyogenic granuloma is a clinical manifestation of what
pregnancy
A pyogenic granuloma is a clinical manifestation of pregnancy and it is a ? lesion, and sometimes called what, and how can this be treated
-benign
-pregnancy tumor
-after surgical removal the tissue returns to health
If a pt is getting aphthous ulcers and herpes labialis what could be causing this
menstruation
Menstruation can cause what glands to become swollen
salivary
In what trimester of pregnancy could you experience these physiology & complications..
-fatigue, syncope, postural hypotension
1st trimester
In what trimester of pregnancy could you experience these physiology & complications..
-BP drops (100/70 mm Hg or lower)
-90% develop benign heart murmur- ends after delivery
2nd trimester
In what trimester of pregnancy could you experience these physiology & complications..
-supine hypotension syndrome
3rd trimester
In what trimester could a pt who is prego experience postural hypotensiom
1st
In the 2nd trimester the ?? drops (give ex)
bp (100/70 or lower)
What percent of prego pt will develop a heart murmur, gives 2 significant details about it. What trimester does this occur in
-90%
-that is the Benign and that it ends after delivery
-2nd
In the 3rd trimester what syndrome might they experience
supine hypotension syndrome
In 90% of prego pt there are ? alterations, and increased ? ?
-taste
-gag reflex
In what % of prego pts is there an increased gag reflex and taste alterations
90%
When a pt is prego what is the contributing factor form GDM
insulin resistance
GDM ? risk for ? and babies that are what size
-increase
-infection
>9 lbs
In prego pt's hypertension increases their risk for ?
preclampsia
Spontaneous abortions of pregnancies account for what percent due to fetal abnormalities
15%
Spontaneous abortions of pregnancies account for 15% due to ? ?
fetal abnormalities
For dental mgmt of a prego pt we need to evaulate and determine ? and ? status, also confirm medical ? care provision or ? entry
-trimester
-health
-prenatal
-facilitate
For dental mgmt of a prego pt we would want to monitor what, and provide what type of therapy, and give them instructions on what. The key word here is ? ? ?
-VS
-periodontal therapy
-OHI
-EDUCATE, EDUCATE, EDUCATE
For dental mgmt with a prego pt we would want to minimize ? use, and ? exposure, what would b a good thing to avoid, and what is the safest trimester for appts
-drug
-radiographic
-avoid prolonged appts
-2nd
Oral contraceptives contain ? & ?, and some clinical manifestations are...
-? gingival ?, and there is more ? destruction if taken over ? years
*? localized ? after mandibular ? ? extractions
-effects of ? on blood ?
-time extraction to day ?-? of cycle
-increased, inflammation, perio, 1.5 yrs
-increased, Osteitis, 3rd molar
-estrogen, clotting
-23-28
If a pt is taking oral contraceptives what day would you want to time the extraction and why
23-28 days of cycle
-b/c estrogen effects on blood clotting
When a pt is going through menopause some clinical manifestations may include...
-? ? syndrome
-? mouth
-menopausal ?
-? ? sensation (give 3 ex's)
-bone ?
-tissue ?
-sensitivity to ? & ?
-alleviation of symptoms with ???
-burning mouth
-dry
-gingivostomatitis
-altered taste (salty, peppery, sour)
-loss
-atrophy
-hot, cold
-HRT (hormone replacmt therapy)
With hormone replacmt therapy, postmenopausal pt have an increased risk for what 2 things
-osteoporosis
-CVD
There are 2 forms of HRT, one is ??? for women ? uterus, and estrogen alone can cause ? of uterine lining; leads to ? cancer
-ERT (estrogen replacmt therapy)
-without
-hyperplasia
-endometrial
The other form of HRT is ? HRT, it contains ? & ? to mimic ? ? of hormones
-combined
-estrogen
-progesterone
-normal release
-Osteoporosis is ? in bone ? associated with ?, ?, and ?
-Affects ?-? ? Americans (what % are women)
-Osteoporotic effects on ? & ? bone -Correlation with systemic osteoporosis & ??? leads to ? loss
-??? protects against osteoporosis & maintains bone ?
-reduction , mass, deformity, fractures, pain
-25-28 million, 80%
-max & mand
-LOA, tooth
-ERT (estrogen replacmt therapy), density
DHPC for hormonal imbalance is that you would develop an effective plan to meet special needs of pts, assess exaggerated responses to local irritants, and would do a thorough periodontal examination consisting of what 3 exams
-gingival assessment
-bleeding index
-periodontal probing
What is the best time to schedule surgeries for pt with hormonal imbalance
on non-estrogen days of cycle (23-28 days of cycle would be best)
DHPC for pt with hormonal imbalance we would have to institute tx modification to address oral manifestations during ?, such as...
-? substitutes
-? supplements
-? deficiencies
-Dentures: promote proper ? & prevent ? spots
-menopause
-saliva
-zinc
-vitamin
-fit, sore
We as clinicians must recognize the association b/t ? ?, ? ?, & ?, and educate the pt about ? effects, b/c most pts are NOT aware of this
-hormonal imbalance
-periodontal dz
-osteoporosis
-oral
What hormone alter rate and pattern of collagen production in gingiva, which results in reduced ability to repair and maintain structure of gingiva
progesterone
What gram negative anaerobic bacteria affect blood clotting, and cause increased bleeding as a hormonal effect
P. intermedia
What gram negative anerobic bacteria cause increased bleeding as a hormonal effect
Capnocytophagia
Porphyromonas gingivalis & Actinobacillus actinomycetemcomitans are 2 bacteria that are ? pathogens that are seen in hormonal effects on oral flora
periodontal