ORAL DISEASE & OSTEOPOROSIS
BY JEAN WACTAWSKI-WENDE
From: ORAL AND WHOLE BODY HEALTH
Research on osteoporosis and oral bone loss has shown a fairly consistent relationship, including a recent University at
Buffalo study that linked osteoporosis and periodontal disease, which caused loss of both oral bone and teeth—especially in women aged 70 years and older.
But other types of studies have produced inconsistent results, or have revealed no connection at all. This is due, in part, to study design variation. For example, several negative studies have included subjects in their 40s and 50s, when osteoporosis and low bone density prevalence is low.
Assessment of both osteoporosis and periodontal disease can also differ across studies, which sometimes makes comparison and interpretation diffi cult.
How does bone loss occur?
Bones are living, growing tissues that undergo constant remodeling in response to the stress placed upon them. About 10 percent of the body’s total bone mass is “remodeled” each year—removed and then replaced. Cells called osteoclasts lay on the bone surface, breaking down existing bone in a process known as resorption. Their counterparts, osteoblasts, then secrete collagen and minerals to lay down new, replacement bone. In osteoporosis, there is an imbalance: Either too much bone is resorbed or too little bone is formed. This skeletal disorder decreases the quality, density (amount) and strength of bone, which becomes abnormally porous and spongy, and fractures easily. According to the National Osteoporosis Foundation, an estimated 10 million Americans have the disease; almost 34 million more have low bone mass. Three quarters of these are women.
Periodontitis, a bacterial infection in the mouth, is the primary cause of tooth loss in adults. It destroys both gum tissue and the alveolar bone that supports the teeth. Researchers are exploring how alveolar bone is lost—and how it may be connected to osteoporosis and body-wide bone loss.
Because osteoporosis is a systemic disease, it may affect bones in the mouth in a number of ways.
Bone loss around teeth may occur independent of oral infl ammation. Osteoporosis may lead to more rapid breakdown of alveolar bone after oral bacteria invades. Systemic factors that affect bone remodeling may also modify how local tissues respond to periodontal infection. http://infinityda.com/oral-disease-osteoporosis/Specifically, people with overall bone loss are known to have increased systemwide production of cytokines (specifically IL-1 and IL-6) that may impact bone quality throughout the body—including the bones of the oral cavity.
Periodontal infection, in turn, increases local cytokine production that boosts local osteoclast activity—accelerating alveolar bone loss.
Both osteoporosis and gum disease share a number of risk factors. Individuals with a genetic predisposition to bone loss are
also more vulnerable to periodontal destruction. Lifestyle factors such as cigarette smoking and low calcium intake as well as the effects of aging may also put individuals at greater risk for low bone density and loss of alveolar bone. Ongoing studies will provide further insight into the interaction of osteoporosis and periodontal bone loss, which will be increasingly important in the prevention of these two very prevalent disorders in older Americans
is associate chair of the Department of Social and
Preventive Medicine at the State University of New York at Buffalo.