Women's Oral Health Research Articles

Oral Health Care Among Women in Perimenopause or Menopause: An Integrative Review.

Women in menopause are at a higher risk of developing oral health problems, affecting their overall quality of life. Several studies have identified the role of health care providers in addressing women's oral health needs across various phases of their lives, yet a review in the area of perimenopause and menopause has not been undertaken. Therefore, the aim of this review was to explore current evidence regarding the oral health knowledge, attitudes, and practices of women in perimenopause or menopause and their health care providers. Additionally, guidelines and recommendations to inform strategies for oral health promotion are included. A systematic search was carried out across 5 databases. Inclusion criteria included articles published in English that examined at least one study outcome: oral health knowledge, attitudes, and practices of either women in perimenopause or menopause or of health care providers or guidelines around oral health care. Qualitative, quantitative, mixed-methods, and experimental studies with survey components were included with no restrictions on publication period, quality, or setting. A total of 12 articles met the inclusion criteria, with a majority being of poor quality and mostly from low-income and middle-income countries. Overall findings indicated that there was a lack of knowledge and limited practices in maintaining oral hygiene and visiting the dentist among women in perimenopause or menopause. Health care providers exhibited poor attitudes in advising the importance of periodic dental check-ups and informing oral health changes during this period. There were also insufficient guidelines to adopt care for women and guide health care providers in their practice. Women in perimenopause or menopause have limited oral health knowledge and unmet oral health needs. Appropriate guidelines and supportive strategies are required to assist health care providers in providing comprehensive care and encouragement to women in perimenopause or menopause to improve their oral health.

Correlation between bone mineral density, vitamin D deficiency, and oral health in women with breast cancer

Breast cancer (BC) survivors treated with aromatase inhibitors (AIs) typically exhibit various pathological issues, including bone loss, poor oral health, and vitamin D deficiency. Nonetheless, chronic oral disorders are even often neglected in women with BC, and explicit indications regarding oral health screening, evaluation, and treatment to prevent cancer treatment-induced bone loss (CTIBL) are lacking. A close link between oral health status and CTIBL might be explained, in part, by the systemic inflammation that characterizes both conditions. In this scenario, the effects of vitamin D (as an inflammation down-regulator) on immune systems are widely acknowledged. Vitamin D might facilitate upregulation of MAP kinases and inhibit the NF-kB signaling pathway, with crucial implications for cytokine serum levels, the prostaglandin inflammation pathway, and the immune cell system. Vitamin D deficiency, smoking, and insufficient usage of dental floss have been found to harm oral health in women with BC receiving AIs. Consequently, vitamin D deficiency screening and supplementation and an appropriate oral rehabilitation strategy should be advised and implemented in the comprehensive therapeutic approach to women with BC treated with AIs. KEY WORDS: Vitamin D, vitamin D deficiency, oral health, periodontal diseases, breast cancer.

IMPACT OF DEPRESSIVE SYMPTOMS ON ORAL HEALTH OF OLDER ADULTS WITH CHRONIC CONDITIONS BY GENDER

Abstract Oral health is crucial for the nutrition and well-being of older adults, especially those with chronic conditions. Although recent studies have demonstrated an association between depressive symptoms and oral health, little is known regarding the gender-specific association between symptoms of depression and oral health among older Korean adults with chronic conditions. Therefore, this study examined the gender-specific relationship between depressive symptoms and oral health, using data from the Korean Longitudinal Study of Aging (2018–2020). Study participants aged 65 or older with one or more chronic conditions were analyzed (N = 1,185 women and 1,919 men). The comprehensive aspects of oral health, including functional limitations, pain, discomfort, and psychological and behavioral impacts, were measured. Generalized Estimation Equation analyses were applied to two models presenting depressive symptoms dichotomously and the severity of depression, respectively. When considering depressive symptoms in dichotomous manner, such as present or absent, having three or more chronic conditions and experiencing cognitive decline were both significantly related to deteriorated oral health for both genders. Moreover, the association between depressive symptoms and deteriorated oral health was more robust in men. While categorizing the severity of depressive symptoms, the worse the depressive symptoms, the poorer the oral health in women. Therefore, this study suggests that interventions to alleviate depressive symptoms could benefit the oral health of both men and women with multiple chronic conditions. For women, targeted interventions based on the severity of depressive symptoms could effectively improve oral health.

Review Paper: Optimized Drug Therapy in Dental Care of Pregnant Women

Pregnancy is a critical stage in oral health of women. The storm of hormones in pregnancy usually cause gingival problems and tooth decay. On the other hand, poor oral health during pregnancy may lead to complications such as premature delivery and preeclampsia. However, while a routine dental care is necessary during pregnancy, drug therapy may be required in some cases such as pain control or management of dental procedures or oral infections. In a pregnant patient requiring dental care, the agents routinely prescribed should be evaluated for potential risks to the mother and/or fetus. On the other hand, many physiological changes occur dur­ing pregnancy to support the needs of the developing fetus and these changes can affect the efficacy and pharmacokinetics of drugs as well. This article aims to provide a comprehensive review of dental drug therapy in pregnancy, including safety and recommendations for commonly used medications in dental practice. The physiological changes during pregnancy and their impact on oral health and drug therapy are discussed with an emphasize on dental therapeutic agents which can be selected in treatment of pregnant patients.

Exploring the experiences and perspectives of women on oral health during pregnancy: A qualitative study in Tasmania, Australia.

To explore women's oral health experiences and barriers to dental care and identify potential strategies to improve oral health during pregnancy. A qualitative descriptive study design was used. Purposively elected antepartum and postpartum women ≥18 years of age from Tasmania, Australia, were recruited using maximum variation sampling. Semi-structured interviews were conducted, and all qualitative data were analysed using an inductive thematic approach. Fifteen women were interviewed with a mean ± SD age of 32.3 ± 4.5 years. Three key themes were generated from the data that described women's perceived changes in their oral health during pregnancy; barriers to oral health care during and after pregnancy; and perceived strategies to improve access to care. Most women acknowledged the importance of maintaining good oral health but reported a decline in their oral health status during pregnancy. Women also identified several barriers to dental care, including treatment costs, competing maternal priorities, limited oral health knowledge and negative perceptions towards dentistry. The provision of preventative oral health care by ANC providers was also limited. Community awareness, patient education resources and assessment tools could support the promotion of oral health care. Women also perceived that interprofessional collaboration between antenatal and dental providers played a key role in promoting oral health. This study explored women's varied oral health experiences and perceptions during pregnancy and highlighted critical barriers and enablers to dental care. Policy-level strategies that promote interprofessional collaboration between antenatal and dental providers and expand dental care access are suggested to overcome barriers to oral health for women during pregnancy.

Awareness regarding oral health among women with polycystic ovary syndrome: a qualitative study

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age. The PCOS primarily affects the reproductive system, with substantial collateral negatively health effects on metabolic, psychologic, and cardiovascular functions. Women with PCOS have increased pro-inflammatory cytokine levels, and this inflammation can lead to several “oral health problems” which are often ignored by patients. This qualitative study aims to explore the knowledge and the impact of oral health in women with PCOS. An in-depth interview was conducted among women with PCOS (aged between 18-35 years) who were diagnosed based on the Rotterdam’s criteria, within the time period of July 2021 to August 2021. Sampling was purposive and continued until data saturation was reached. Data were analysed using the thematic analysis technique with NVIVO 10.0 software (Numerical Analytics Instruments). The analysis of the data helped to extract the main theme of the research as “PCOS impact on oral health” under 3 main category themes and 8 sub-category themes. There is a need for education at the community level to increase general awareness and to understand the condition. Better awareness could also help women to recognise possible symptoms and prompt them to seek help, leading to more timely diagnoses.

Attitudes and barriers of pregnant women toward prenatal oral health care at antenatal centers of Mosul City, Iraq

Objective: To evaluate pregnant women's attitudes on oral health and the obstacles to promoting it. Methodology: This descriptive, cross-sectional study was carried out from 10th of September, 2022 to 20th of October, 2022. It included 155 pregnant ladies chosen using simple random sampling, and data were collected from 6 antenatal care centers in Mosul city. We used a structured interviewing questionnaire. Results: Average age of women was 28 years and 54.8% agreed that maintaining good oral health during pregnancy affects the health of the fetus. More than 54% said their greatest obstacle to promoting good oral health during pregnancy was their fear that dental treatments will harm the fetus. Conclusion: Most of the study participants had a good attitude toward improving pregnant women's oral health. However, they were afraid that dental treatments will harm their fetuses.

Insight to oral health status, knowledge and practices of Saudi Pregnant women

Background: Pregnancy is a time of increased susceptibility in terms of dental health due to typical physiological changes. Pregnant women with better oral health are less likely to experience pregnancy-related dental disease problems.Methodology: This cross-sectional study was conducted at college of dentistry, Qassim university, Qassim province of Saudi Arabia. A piloted tested self-administered questionnaire was used to collect data which was available in Arabic and English languages. Data collection was done through social media platform among pregnant women. Pearson's chi-square test was used to analysehe difference of opinions among different trimester of pregnant women’s.Result: In the present study, 208 pregnant women’s responded to online forms through social media platform, with mean age of participants was 33.10 ±8.11. Significantly, higher number of second trimester woman reported dental problem and majority of them attended private dental clinic. The majority of women’s were dissatisfied about the instruction given by gynecologist for dental care. But surprisingly, significantly higher number of women were aware about the aware about eruption time of baby tooth and harmful effect of bottle-feeding.Conclusion: Saudi women's oral health knowledge and practices need to be improved in order to prevent dental and oral diseases and to motivate them to receive routine dental care in order to ward off additional illness.

Incarceration exposure and women's oral health experiences during pregnancy

RationalePrior research has documented an association between incarceration and poor oral health outcomes. Likewise, recent scholarship has also detailed that women exposed to incarceration either directly or vicariously through a partner during pregnancy incur worse health outcomes. However, no previous research has assessed the connection between incarceration exposure and oral health during pregnancy. ObjectiveThe current study assesses the link between maternal incarceration exposure and oral health during pregnancy. MethodsData are from the Pregnancy Risk Assessment Monitoring System (PRAMS) from years 2016–2019 (N = 60,342). Logistic regression was used to assess the relationship between incarceration and oral health. ResultsWomen exposed to incarceration exhibited worse oral health outcomes in the form of being more likely to report not knowing the importance of oral care, not having an oral health discussion with a provider, not getting a teeth cleaning, as well as being likely to report needing to see a dental provider, having visited a dental provider for a problem during pregnancy, and having more unmet dental care needs. ConclusionsThese findings add to a burgeoning literature that demonstrates a woman's prenatal exposure to incarceration poses risk for overall health and wellbeing. Given the influence of both incarceration exposure and oral health during pregnancy for maternal and infant health, the findings suggest that coordination between criminal justice, public health, and oral health experts can develop programmatic efforts that expand access to oral health care and improve oral health literacy among incarceration-exposed pregnant women.

Evaluation of Oral Health Status Among Pregnant Women Using Oral Hygiene Index- Simplified (OHI-S) Score

Background: Oral health of women is often neglected during pregnancy. We need to address this issue in a developing country’s perspective,as oral healthcare is not an integral part of antenatal protocols.Objective: To evaluate the oral health status of pregnant women using Oral Hygiene Index-Simplified (OHI-S) Score as well as explore oral hygiene practice by them and conduct a mini-assessment of their knowledge of oral health.Methods: This cross-sectional, descriptive study was conducted using data by using a semi-structured questionnaire among 170 pregnant women attending an antenatal center in Dhaka city, Bangladesh,from March to August of 2018. A pre-tested semi structured questionnaire containing OHI-S indexwas used for data collection. Dental mirror and probe were used for oral hygiene assessment.Results: The mean age of the participants was 24.22±5.07 years. 140(82.4%) were found to use toothbrushes as a tooth-cleaning aid and 146(85.9%) used toothpaste as a tooth cleaning material. Among them, 132(94.3%) were found to brush at least once a day. The predominant health problems identified by clinical examination among those pregnant women were gum bleeding, mild to severe periodontitis, halitosis (bad breath) and loose teeth. The majority didnot know the safe period of dental treatment and the consequences of having poor oral health during pregnancy. The overall oral hygiene status of the maximum pregnant women was ‘Fair’ (50.6%) (OHI-S score 0-1.2), while 39.4% had ‘Poor’ oral hygiene status (OHI-S score 1.3-3.0) and only 10% had ‘Good’ oral hygiene status (OHI-S score 3.1-6.9).Conclusion: Pregnant women in Bangladesh suffer from various oral health issues during pregnancy; however, they exhibit that they do not address this issue due to lack of awareness and other factors. Hence, it is crucial to plan and implement effective oral health programmes for pregnant women all over the country.International Journal of Human and Health Sciences Vol. 06 No. 03 July’22 Page: 298-303

Comparing oral health behaviours of men and women in the United States

ObjectiveThis study used a national database to update and examine current differences in men's and women's oral health and oral health behaviours in the United States. MethodsData from the National Health and Nutrition Examination Survey for the 2017–2018 cycle were used to explore the relationship between males and females and their oral health. Multivariate analyses assessed for gender differences in oral health behaviors between genders after controlling for sample demographic characteristics. ResultsThe final sample consisted of 4,741 participants. Males tended to have fewer dental visits, worse perception of their gum and tooth health, poorer flossing habits, and more root caries. Females were more proactive in visiting dentists and displayed a greater awareness of oral health. Females were less likely to report discussing oral cancer screening with their dentist even though they were screened more often. On examination, males were more often advised to seek urgent dental care than females. All these differences were statistically significant at p<0.05, although the effect size for examination variables was small (Phi <0.1). ConclusionsOral health and oral health behaviours demonstrate gender differences with men reporting poorer oral health, poorer oral hygiene habits, and fewer dental visits. These findings suggest gender-targeted strategies have the potential to improve oral health and reduce gender-related disparities. Clinical SignificanceThis study found that women exhibit better oral health practices and behaviours. These differences may cause a disproportionate burden of oral disease in men and highlight the need for dentists, hygienists, and those interested in dental public health to develop gender-specific strategies to address these inequalities.

Knowledge and Practices of Oral Health Status among Pregnant Women Attending Liaquat University Hospital Jamshoro

Background: Pregnant women's oral health behaviors and attitudes are infrequently studied in low-income countries, but they should be taken into account when developing preventive or therapeutic research to lessen the load of oral illnesses.&#x0D; Objective: To assess the knowledge and practices of oral health in pregnant women attending Oral diagnosis outpatient department OPD of Liaquat university hospital Jamshoro.&#x0D; Subject and Methods: A total of 150 patients were included in the study. Data was collected by providing questionnaire to pregnant women who attended OPD for their antenatal check up. Socidemographic findings, questions related to participant’s knowledge regarding oral health and practices adopted were recorded.&#x0D; Results: Most of the patients, 49.3% were in age range of 26 to 35 years with the majority of them being housewives. A total of 48% were illiterate followed by 24.6% who had only just primary education. Around 51.3% have the good habit of brushing twice a day. Only 37.3% had knowledge about nutritional implications in pregnancy, and 34% visit dentist once in six months.&#x0D; Conclusion: The majority of patients has little or average knowledge regarding oral health in pregnancy.

Postpartum U.S. Women's Oral Health Knowledge, Attitudes, and Practices During Pregnancy.

The purpose of this study was to assess oral health knowledge, attitudes, and practices of women who had given birth in the United States within the past 2 years, and to evaluate factors affecting women's dental service utilization during pregnancy. This study used a descriptive, cross-sectional design and employed non-probability sampling methods. The 47-item questionnaire included: oral health behaviors (8), knowledge (5), attitudes (12), and practices during pregnancy (10), and demographic (12) questions. Participants were recruited through multiple postpartum support group forums on Facebook. Logistic regression was used to identify potential predictors of dental utilization during pregnancy. Ninety-one percent of the participants had at least an associate's degree, and 85.6% had dental insurance coverage during pregnancy. Approximately 56% knew the connection between poor oral health and pregnancy complications; however, only 11% obtained this information from their OBGYNs and 10% from their dental offices. Although women aware of the association were more likely to visit the dental office during pregnancy (64%, p < .001), the majority (74%) who experienced tooth or gum related issues during pregnancy reported not receiving any dental or gum treatment. Women, who had positive dental attitudes and awareness of an increased risk of pregnancy complications due to poor oral health, were more likely to receive dental care during pregnancy regardless of dental coverage. Medical and dental providers could play an active role in educating women on the importance of having good oral health, potential oral/systemic relationships, and the benefits of receiving dental care during pregnancy.

Does having children affect women's oral health? Alongitudinal study.

Many believe women's oral health deteriorates as a result of having children. If so, such associations should exist among women but not among men. The aims of this study were to investigate whether number of children is associated with experience of dental disease and tooth loss among both men and women and to examine whether this association is affected by other variables of interest. This study used data from the Dunedin Multidisciplinary Health and Development study, a longitudinal study of 1037 individuals (48.4% female) born from April 1972 to March 1973 in Dunedin, New Zealand, who have been examined repeatedly from birth to age 45 years. Data were available for 437 women and 431 men. Those with low educational attainment were more likely to have more children and began having children earlier in life. Having more children was associated with experiencing more dental caries and tooth loss by age 45, but this association was dependent on the age at which the children were had. Those entering parenthood earlier in life (by age 26) had poorer dental health than those entering parenthood later in life, or those without children. There was no association between number of children and periodontal attachment loss (PAL). Low educational attainment, poor plaque control, never routine dental attendance, and smoking (for PAL) were associated with PAL, caries experience, and tooth loss. Social factors associated with both the timing of reproductive patterns and health behaviors influence the risk of dental disease and its management.

Correlation of knowledge and attitude on the practice of pregnant women’s oral health

Introduction: During pregnancy, hormonal changes can increase susceptibility to oral diseases. Oral disease can pose a risk for the baby's oral health and pregnancy outcomes. Oral problems and their complications during pregnancy can be prevented by maintaining oral health behaviours that include knowledge, attitude, and practice. This study was aimed to analyse the correlation of knowledge and attitude on the practice of pregnant women's oral health. Methods: A descriptive-analytic research with a cross-sectional method was conducted towards 65 pregnant women at Sukajadi Community Health Centre (Puskesmas), Bandung, taken as a sample through purposive sampling technique. Data collection was carried out using a questionnaire. The statistical test used in this study was the Spearman correlation test. Results: The study showed that 66.2% of pregnant women had good knowledge of oral health care, 27.7% had adequate knowledge, and 6.2% had poor knowledge. Observation on oral health care attitude found that 56.9% of pregnant women had a good attitude, 43.1% had a fair attitude, and none were in the poor category. Oral health care practice of pregnant women resulted from 15.4% was in a good category, 60.0% in the fair category and 24.6% was in the poor category. The statistical analysis results between the attitude and the practice of oral health care showed a weak correlation with the correlation coefficient (rs) 0.124 and a significance value (p-value) was higher than 0.05 (0.325), indicating that there was no significant relationship between attitudes and the practice of oral health care. Conclusion: There is no correlation between knowledge and attitude on the practice of pregnant women's oral health.

ATENÇÃO À SAÚDE BUCAL DE GESTANTES NO BRASIL: UMA REVISÃO INTEGRATIVA

Introdução: O acompanhamento odontológico das gestantes pode propiciar inúmeros benefícios para a mãe e o bebê. Entretanto, ainda não são todas as gestantes que têm acesso ao pré-natal odontológico no Brasil, embora atenção à saúde de forma integral seja uma prioridade no período gestacional. Objetivo: O presente estudo objetivou identificar os aspectos gerais da atenção à saúde bucal das gestantes brasileiras atendidas na Atenção Básica de saúde disponíveis nas publicações científicas. Metodologia: Trata-se de um estudo de revisão integrativa da literatura. A pesquisa dos artigos foi realizada nas bases de dados Medline, Lilacs, BBO e SciELO, considerando o intervalo de ano de publicação entre 2010 e 2020. Resultados: Foram selecionados 17 artigos científicos, cujo conteúdo foi categorizado em quatro conjuntos: Conhecimento das gestantes acerca da saúde bucal, Hábitos de higiene bucal das gestantes, Condição de saúde bucal das gestantes e Atenção à saúde bucal das gestantes. Ainda existe desconhecimento de muitas gestantes sobre o que é o pré-natal odontológico e sua importância. Estudos apontam que algumas não são orientadas durante o pré-natal a realizar consultas com o cirurgião-dentista. As gestantes usam a escova e creme dental habitualmente, mas o fio dental não faz parte da rotina de higienização bucal. Dentre os problemas bucais, a cárie e a doença periodontal podem ser encontradas com maior frequência, principalmente entre as gestantes que possuem uma menor renda e menor nível de escolaridade. Foi mais comum as gestantes estarem inseridas em ações de educação em saúde. Conclusão: Conclui-se que as gestantes atendidas na Atenção Básica de saúde possuem poucas informações sobre saúde bucal, convivem com os mitos odontológicos e apresentam medo de se submeter à assistência por meio do tratamento odontológico durante o período gestacional. Ademais, apresentam saúde bucal precária e encontram barreiras no acesso aos serviços de saúde bucal.

Oral Health in Women with a History of High Gestational Diabetes Risk.

We studied oral health in 115 women with and without a history of gestational diabetes (GDM), expecting poorer oral health in the GDM group. Full-mouth examinations were performed 5 years postpartum and the number of teeth, total dental index (TDI) and decayed, missing, filled teeth (DMFT) index were calculated. Bleeding on probing (BOP), probing depth (PD), visible plaque index (VPI), and clinical attachment level (CAL) were recorded. The periodontal inflammatory burden index (PIBI) was calculated. Panoramic radiographs were taken and signs of infections recorded. Oral health habits, symptoms and participants’ own opinion of oral health were recorded with questionnaires. At the time of examination, 45% of the women had a history of GDM in the index pregnancy. Mild periodontitis (62%) and bleeding on probing (46%) were common. VPI (13% and 17%, p = 0.009) and PIBI (13.1 and 17.5, p = 0.041) were lower among women with a history of GDM compared with those with no history of GDM. There was no difference between groups in DMFT scores. All women reported good subjective oral health. Thus, contrary to our hypothesis, women with a history of GDM showed better oral health parameters than women without a history of GDM.

"I Didn't Know": Pregnant Women's Oral Health Literacy Experiences and Future Intervention Preferences.

This study explored women's 1) experiences in accessing, understanding, appraising, and applying oral health information and services, and 2) preferences regarding oral health promotion during pregnancy. Pregnant women ages 18 to 45 were recruited from an obstetrics and gynecology clinic at a large university hospital. Focus groups were conducted using the four domains of the integrated model of health literacy (access, understand, appraise, apply) and were audio-recorded and professionally transcribed. Thematic analysis was employed using Atlas.ti. Participants (n=17) were Hispanic (53%), married (67%), college educated (87%), employed (80%), and insured (100%). Most participants reported not accessing or receiving oral health information during pregnancy, with limited information received from less trustworthy sources (Internet; friends/family) and focusing on symptoms or myths. Participants revealed gaps in basic oral health understanding and demonstrated limited ability to evaluate or apply information, such as engaging in positive oral health behaviors, according to their needs and personal health status. Participants strongly desired that oral health promotion be integrated into prenatal care. Participants described missed opportunities to improve oral health literacy and desire future health messages that facilitate patient-provider communication on oral health during prenatal care visits. Futurehealth interventions should convey the importance and associated risks, be time efficient and patient centered, and include patient activation to prompt oral health-seeking behaviors during pregnancy.

Integrating Oral Health Curricula into Midwifery Graduate Programs: Results of a US Survey.

Midwives are a significant segment of the US maternal and primary health care workforce and play a pivotal role in addressing women's oral health care needs during pregnancy and throughout their life span. The purpose of this research was to assess oral health curricular integration in midwifery programs and examine factors that influence integration and satisfaction with graduates' level of oral health competence. A cross-sectional, national survey of midwifery programs was conducted using an electronically distributed 19-item, self-administered questionnaire completed by the Directors of Midwifery Education. Data analysis included univariate and bivariate statistics. All of the responding midwifery programs (N = 33) were educating their graduates about oral health; however, less than a quarter (22.6%) of program directors were satisfied with their graduates' competency. Significant factors promoting integration were routine teaching by a dental professional and a formal relationship with a dental school, dental residency, or dental hygiene program. Programs with 4 or more hours of oral health curriculum were more likely to have a faculty oral health champion, use simulation in evaluation of their learners, and include interprofessional oral health education. With adequate oral health education, midwives are ideally positioned to integrate oral health in pregnancy care as well as well woman care throughout the life span, thereby expanding access to oral health care.

'One tooth one child': evaluating the effects of diet and fertility on the oral health of women from archaeological sites in South America.

Women from ancient societies have shown a higher prevalence of dental caries in comparison with men. Recent research has shown that the relationship between increased oestrogen production during pregnancy and decreased salivary flow is a possible cause for the higher levels of caries in women, which is in contrast to the traditional view of sexual division of labour resulting in unequal access to cariogenic food. In order to test these two hypotheses, individuals exhumed from 12 South American archaeological sites were examined for markers of oral health (caries, ante mortem tooth loss, deep caries, and enamel hypoplasia) and compared in terms of fertility (Crude Birth Rate) and subsistence systems. Our results suggest that diet and other cultural practices remain the most important factors affecting oral health and that the effects of hormones can be masked by them. Such findings add to the discussion regarding the availability of micronutrients in such societies affecting caries experience in pregnant women, because of their special nutritional requirements.