Departments
Health Matters
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Week of 2 October 1998 |
Vol. II, No. 8 |
Health Matters
Osteoporosis may also lead to tooth loss
I am a 55-year-old woman, and lately I have been experiencing problems with tooth loss. I recently read that tooth loss may be related to osteoporosis. Should I check with my physician about getting screened for the condition?
The latest research suggests that tooth loss may indeed be related to osteoporosis, a bone loss condition affecting mainly older women.
A recent groundbreaking study conducted jointly by Boston University's Goldman School of Dental Medicine (GSDM) and the Human Nutrition Research Center on Aging at Tufts University indicates that postmenopausal women may suffer from tooth loss because of an increased loss of the alveolar bone (the portion of the jaw that helps support teeth). Osteoporosis affects 25 percent of women over 45 and 90 percent over 75 and can lead to fractures.
"Women with osteoporosis are more likely to have special oral needs and may experience difficulty keeping their natural teeth, dentures, or implants," says Elizabeth Krall, lead author of the study and associate professor of health policy and health services research at GSDM. "It may be appropriate for older women who experience unexplained tooth loss to seek a bone density evaluation to test for osteoporosis."
The study followed 189 healthy postmenopausal Caucasian women over the course of seven years and found that the 24 percent who lost at least one tooth also had a faster decrease in bone mineral density from the hip and whole body. In women whose bone loss from the whole body was twice the usual rate of one percent per year, the risk of tooth loss more than quadrupled. In addition, a similar increase in bone mineral density loss in the hips or spine increased the risk of tooth loss by 50 percent and 45 percent respectively.
"After middle age, men and women lose bone density, and this is thought to be due to a number of factors, such as poor diet, smoking, alcohol, heredity, and physical inactivity," Krall says. "Therefore, a nutritious calcium-rich diet, physical activity, and staying away from cigarettes and alcohol will help fight osteoporosis." She adds that hormonal and drug therapies used to fight osteoporosis may also help retain teeth by preserving the alveolar bone.
Krall also points out that postmenopausal women are subject to an estrogen withdrawal, which makes it important for them, especially those whose family history includes osteoporosis, to be evaluated by their physician for possible estrogen supplementation. "When women go through menopause and experience an estrogen withdrawal, they need to try and preserve bone density. The supplement will do that," she says.
Although there are no clear early-warning signs of osteoporosis, Krall says, a person's family history may be the best warning that the person has a higher risk. "Usually the first sign of osteoporosis is a fracture -- and that's pretty late. Other than that, there really are no early signs -- except by use of bone density evaluations."
Krall believes dentists can play a role in the early detection of osteoporosis. "Tooth loss doesn't necessarily mean osteoporosis is very advanced. If dentists were more aware, they could play a greater role in screening patients."
"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on osteoporosis or other health matters, call 638-6767.