Periodontal Disease and Osteoporosis and Osseonecrosis of the Jaw Bone
Periodontal disease is characterized by a progressive loss of supportive gingival tissue in the gums and jawbone. It is the number one cause of tooth loss among adults in the developed world. Periodontal disease occurs when toxins found in oral plaque inflame and irritate the soft tissues surrounding the teeth. If left untreated, bacteria colonies initially cause the systematic destruction of gum tissue, and then proceed to destroy the underlying bone tissue.
Osteoporosis is a common metabolic bone disease which frequently occurs in postmenopausal women, and occurs less frequently in men. Osteoporosis is characterized by bone fragility, low bone mass and a decrease in bone mineral density. Many studies have explored and identified a connection between periodontal disease and osteoporosis.
A study conducted at the University of New York at Buffalo in 1995 concluded that post-menopausal women who suffered from osteoporosis were 86% more likely to also develop periodontal disease.
Reasons for the Connection
Though studies are still being conducted in order to further assess the extent of the relationship between osteoporosis and periodontal disease, the researchers have thus far made the following connections:
- Estrogen deficiency – Estrogen deficiency accompanies menopause and also speeds up the progression of oral bone loss. The lack of estrogen accelerates the rate of attachment loss (fibers and tissues which keep the teeth stable are destroyed).
- Low mineral bone density – This is thought to be one of several causes of osteoporosis, and the inflammation from periodontal disease makes weakened bones more prone to break down. This is why periodontitis can be more progressive in patients with osteoporosis.
Diagnosis and Treatment
Osteoporosis and periodontal disease are much less dangerous if they are diagnosed in the early stages. Once a diagnosis has been made, your dentist and your periodontist will generally work with the patient’s doctor to ensure that both diseases are effectively controlled.
Here are some methods commonly used to diagnose and treat the diseases:
- Routine dental x-rays – X-rays can be effectively used to screen for bone loss in the upper and lower jaw, and the dentist can provide interventions for preventing and treating periodontal disease. It is believed that minimizing periodontal disease will help treat osteoporosis.
- Estrogen supplements – Providing post-menopausal women with estrogen supplements lowers the rate of attachment loss and also lowers gingival inflammation, which in turn protects the teeth from periodontal disease.
- Assessment of risk factors – Dentists and doctors are able to closely monitor the patients that are at an increased risk of developing both diseases by assessing family history, medical history, X-ray results, current medications and modifiable risk factors. Tobacco use, obesity, poor diet and estrogen deficiency can all be managed using a combination of education, support and prescription medications.
Osseoinecrosis of the jaw: A small percentage of those who have been treated for osteoporosis thru Bishphosphonate medications, have shown a complication after oral surgical procedures known as “osseonecrosis of the jaw bone”. The odds to develop this condition seems to be higher in those receiving their medications as an IV injection. For those who receive their medications orally, the odds of developing this condition is much lower. The procedures that put the patient at risk for osseonecrosis are those that involve exposing the bone. Even extraction of the teeth can be a risk in developing osseonecrosis. Common medications are Fosomax, and Boniva.
If you have any questions about periodontal disease and its connection with osteoporosis, please ask Dr. Bashiri and staff.