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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

By studying only women without significant periodontal disease, the study by Civitelli et al¹ skirts the important and largely ignored issue of a potential primary and destructive influence of the lack of estrogen on periodontal tissues. Much evidence suggests that such an influence may contribute to the development of periodontitis in postmenopausal women, independent of the influence of the lack of estrogen on alveolar bone.

During and after menopause, the association between estrogen deficiency and tooth loss is usually explained by a cycle of self-perpetuating events triggered either by alveolar bone loss accelerated by the lack of estrogen or by periodontitis. Loss of alveolar bone in these women results in retraction of gum margins, exposure of tooth surfaces not protected by enamel, loss of ligamentous attachment, pocket formation, and development of periodontitis, which further stimulates bone resorption until tooth sockets are inadequate for tooth retention.

The influence of estrogen deficiency . . . [Full Text of this Article]