Osteoporosis is a condition in which the bones become less dense making them more likely to fracture. The term “porosis” means spongy, which describes the appearance of bones when they are broken in half and the inside is examined. Normal bone marrow has small holes within it, but a bone with osteoporosis will have much larger holes. It can affect any bone in the body, even the jawbone in the mouth that helps support and hold your teeth in place. Your teeth depend on a healthy jawbone, so it’s important to understand that caring for these dental bones is just as critical as caring for your teeth and gums.
Oral Bone Loss
The elevated ridge of bone that surrounds and forms the sockets for your teeth is called the alveolar process. This ridge of bone is essential in keeping your teeth well supported to prevent tooth loss. When this bone begins to wear away (resorb), there is less support for the teeth and they eventually begin to become loose. A tooth can be so loose that chewing becomes difficult and it may eventually fall out on it’s own or have to be removed. Although bone is a living, growing, calcified tissue that is constantly renewed through a process called remodelling (old bone is taken away and replaced with new bone), as we age, once bone is lost, it is very difficult to replace. additionally, bone loss in the mouth triggers a whole host of other dental issues. Interestingly. a study concluded that loss of alveolar bone height was three times higher in patients with osteoporosis.
Osteoporosis and Gum Disease
Gum disease (periodontal disease) can also lead to alveolar bone loss, so it’s no surprise that there is a connection between osteoporosis and gum disease. These two conditions are both:
- Characterized by loss of bone density
- Commonly affect middle-aged and elderly women.
- Share risk factors, including tobacco use, nutrition, age, gender, and menopause.
- Linked to systemic inflammation and are worsened by the inflammatory response
- Preventable and reversible through dietary and lifestyle changes
Osteoporosis and Dental Treatment
It’s important to let your dentist know about all the medications that you take, especially if you are using biophosphates as an osteoporosis remedy.
Bisphosphonates are group of drugs that inhibit bone resorption in a number of conditions including osteoporosis. Your dentist may need to modify your dental treatment as the most common complication in patients on bisphosphonate therapy is osteonecrosis of jaw (death of the bone) which can occur after any surgical dental procedure.
Your dentist will also want to use extra precaution when applying force to a jawbone as in the case of dental extraction, while preventative and non-invasive treatments can usually be performed without any special considerations.
Although osteoporosis affects everyone, studies have also shown that alveolar loss is more significant in women as compared to men. In fact, woman have a 5X greater risk than men in developing osteoporosis. During menopause there is increased bone loss due to reduced estrogen production. There also seems to be an early estrogen deficiency in women who experience menopause before age 45. Women are encouraged to speak with their family doctor about their estrogen replacement options.
There is no method of determining the actual structure of bones without actually removing a piece during a biopsy (which is not practical or necessary). Instead, the diagnosis of osteoporosis depends on x-rays. A dental office is the only place where a person may have x-rays taken on a regular basis – usually at their checkup visits. Because of this, dentists are uniquely situated to be one of the first healthcare providers to recognise the loss of bone density in a patient through these x-rays and to encourage them to speak with their family doctors about additional osteoporosis screening x-rays. Dentists may also associate other dental problems with low bone density such as gum recession, loose dentures, bad breath, sore jaws in addition to the aforementioned loose teeth.
The identified risk factors for osteoporosis are:
- advancing age
- female gender (especially postmenopausal)
- family history
- calcium and vitamin D deficiency
- inactive lifestyle with little exercise
- certain medications (steroids, thyroxin, anti-epileptics)
- chronic diseases
- thin, small-boned frame
- tobacco use
- excessive use of alcohol
Osteoporosis is a complex disease and not all of its causes are known, but did you know that osteoporosis is preventable if bone loss is detected early enough? When certain risk factors are present, your likelihood of developing osteoporosis is increased. Therefore, it is critical for you to determine your risk and take action to prevent it as soon as possible.
The safest and probably the most effective source of calcium and other minerals for strong bones and overall health is diet. Many researchers conclude that taking a calcium supplement is not sufficient in providing the body with enough nutrients and their use comes with a host of side affects such as constipation, indigestion, and an increased susceptibility to heart disease and the formation of kidney stones. However, the benefits of calcium supplements are likely to far outweigh any risks for those people who are already fracture-prone because of osteoporosis.
A high-calcium diet is key to preventing osteoporosis and oral health issues and includes foods such as:
- dairy products such as milk and plain yogurt
- calcium-fortified orange juice, soy milk and rice milk
- calcium fortified tofu
Additionally, people seeking to preserve their bones may want to consider regular weight-bearing or strength-building exercises, or both. Walking, running, weight lifting and working out on resistance machines is also effective and safe for most adults, if done properly.
If you think you have oral health issues due to osteoporosis, speak to your dentist today.
Yours in Better Dental Health,
The Your Smile Dental Care Team
(905) 576-4537 Oshawa
(416) 783-3533 Toronto