Osteoporosis And Oral Health

Importance:

Bone loss is a central, common feature of both periodontal disease and osteoporosis. Osteopenia, or low bone mineral density (BMD), results when bone metabolism becomes unbalanced causing bone resorption to occur at a faster rate than bone production. In periodontal disease, oral inflammation due to chronic infection of the tissue around the teeth results in destruction of oral bone and periodontal ligament (see Figure 1), ultimately leading to tooth loss. Oral inflammation increases production of inflammatory proteins that stimulate bone resorption. A similar mechanism may contribute to osteoporosis, raising the question of whether people with low skeletal BMD are at increased risk of oral osteopenia (Figure 1). Recent research suggests a relationship between osteoporosis and periodontal disease.1

Risk factors are common to both conditions. Both osteoporosis and periodontal disease become more prevalent with advancing age, and individuals with a family history are at a higher risk. In women, estrogen deficiency increases the risk of both oral and systemic osteopenia. Smoking is a risk factor for and hastens the progression of both conditions.

Patient Management:

Based on the common characteristics of periodontitis and osteoporosis, determining the root cause of tooth loss when both pathologies are present is difficult. However, dental professionals can address both periodontitis and systemic osteoporosis. First, a thorough medical history should be taken and reviewed with the patient. Any signs or symptoms of osteoporosis should be documented and communicated to the patient, with a referral to a physician for evaluation. The oral health status should also be evaluated and treatment rendered based on the diagnosis. Emphasis should be placed on the reduction of the plaque and accompanying inflammation, both supragingivally and subgingivally. Home care should be reinforced and patients should be encouraged to floss regularly and to brush twice daily with a dentifrice that offers antibacterial protection and antiinflammatory benefits.

Reference

  1. Ann Periodontol. 2001;6:209-213.

Colgate® Total® contains a patented triclosan/ copolymer formulation, which provides clinically proven 12-hour antibacterial protection, plus anti-inflammatory benefits.

*Colgate Total® is approved for the prevention of gingivitis, not approved for the prevention or treatment of periodontitis or other diseases.