Tomorrow is World Osteoporosis Day
There is a clear link between osteoporosis and periodontal disease, according to new research.
Commenting on the research, Professor Robin Seymour an independent periodontologist from the Simplyhealth Advisory Research Panel (ShARP) notes: “This new research is the result of two large scale National Health Studies. Data from both studies confirmed a clear association between osteoporosis and periodontitis and concluded that women with a history of periodontitis or osteoporosis experience accelerated bone and tooth loss which is bad news. These latest data findings supports previous results including research involving 49 patients with osteoporosis which showed periodontal status declining significantly over a 2-year period.
“So why should osteoporosis be a risk to oral health. What is clear from the research is that decreased bone mineral density thanks to osteoporosis gives rise to more rapid resorption of the bone in the jaw. Systemic reduction in bone remodelling also modifies the response of the periodontal tissues to bacterial plaque. In addition, the reduction in circulating oestrogen levels during menopause has an adverse effect on the periodontium and the response to plaque too.
“As a result, patients suffering from osteoporosis have fewer teeth.
“Periodontal disease or gum disease also affects the tissues that support the teeth. However, the bad news is that periodontitis is not just limited to lost and bleeding gums. Studies continue to demonstrate an association between peridontitis, stroke and cardiovascular disease. New research is showing that gum inflammation might cause inflammatory effects elsewhere in the body, including the arteries. Researchers also think bacteria in periodontal pockets around the teeth could go on to circulate around the vascular system, where they play a part in the build-up of plaque in arteries.
“So we have a clear link emerging between osteoporosis and periodontitis with periodontitis being linked also to coronary heart disease and stroke.
“As a result, patients who suffer from osteoporosis should undergo regular 6-monthly dental inspections, and in particular need to have a thorough inspection of their periodontal tissues. I would like to see a national screening programme introduced for those patients with osteoporosis or who may be at risk from the disease. In addition, if a patient smokes, then dentists need to advise of the increased risk that osteoporosis can cause on all teeth and their supporting structures and play a role in helping patients sign up to a smoking cessation programmes.
“Any underlying periodontal disease must be treated and all patients need encouragement as to why maintaining good oral care is essential.
“Plaque control is of paramount importance and any measure to reduce and maintain low plaque scores should be encouraged.
Patients should also be given dietary advice, especially consuming a diet rich in foods full of flavonoids and anti-oxidants.”
Professor Seymour adds: “Osteoporotic patients need to also enquire whether treatment for their osteoporosis could reduce the risk of periodontal disease and tooth loss. Oestrogen supplementation in postmenopausal women has been shown to reduce gingival inflammation and the frequency of periodontal destruction. This medication appears to be most useful in the early stages of the menopause.
“Oral bisphosphonates are widely used in the management of osteoporosis. Although these drugs are efficacious in reducing bone turnover, this benefit is not translated to the periodontal tissues. Patients taking bisphosphonates do not appear to be afforded any degree of protection against periodontal breakdown.”
Osteoporosis – the facts
Osteoporosis is a common chronic condition in which there is a decrease in bone mineral density making them more susceptible to fracture.
It has been estimated that one in three postmenopausal women over the age of 50 years suffer from osteoporosis.
Loss of bone from the alveolar – the part of the upper and lower jaw that contains the teeth sockets – is also a significant part of periodontal disease. It is therefore not surprising that there has been considerable interest in whether osteoporosis is a significant risk factor for periodontal disease and tooth loss.
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