Many people experience osteoporosis as they age. The numbers have created a major health problem affecting middle-aged and older individuals. Osteoporosis results in reduced bone mass and strength, which leads to an increased susceptibility to fractures. The condition damages the ability of bones to produce new tissue that makes up their spongy interior. You may wonder whether this condition affects your teeth. Are teeth made of bone?
Teeth are not bones, so your teeth aren’t subject to the same issues as the living tissue in your bones. However, the disease is associated with several risk factors and evidence suggests there may be a connection to oral health conditions that affect teeth such as periodontal disease, reduced jaw bone density, and tooth loss.
In this article, our team at Sninski & Schmitt Family Dentistry explores the possible connection between osteoporosis and your teeth, if the condition can impact oral health, and how you can take preventive measures.
What is Osteoporosis?
Osteoporosis is a disease that causes bones to become weak and more likely to break. It’s also known as a “silent disease” because there are usually no symptoms until a bone breaks. It occurs when bones lose minerals like calcium faster than the body can replace them, making bones less dense and more likely to break. Many people experience spine fractures with osteoporosis that cause severe back pain, loss of height, and a stooped posture.
Age, gender, family history, and lifestyle choices are common risk factors for osteoporosis. Treatments include medications, dietary modifications, exercise, and supplements. In particular, weight-bearing exercises can help strengthen bones and muscles and improve balance. Exercises that work against gravity, like walking, yoga, Pilates, and tai chi, can be beneficial. Supplements such as calcium and vitamin D can also help with osteoporosis.
The Link Between Osteoporosis and Teeth
Osteoporosis has been associated with a higher risk of tooth loss due to compromised bone density. Reduced bone mass in the jaw may affect the stability and support of teeth, resulting in an increased likelihood of tooth mobility and subsequent loss.
It’s easy to mistake teeth for bones because the enamel covering the crown of your teeth looks like bone. But, enamel is not made of living tissue like a bone. However, because teeth are embedded in your jawbone, the health of your bones has a direct impact on oral health.
Osteoporosis and Bone Loss in the Jaw
The tooth root fits into a socket within the jawbone, anchored by connective tissue fibers called periodontal ligaments. Ordinary activities like chewing and biting can be negatively affected if the alveolar bone that anchors your teeth into your mouth doesn’t receive the necessary stimulation, causing it to break down.
When the jawbone is weakened, teeth may shift or become loose, causing facial changes like a sunken appearance, difficulty chewing, jaw pain, and gum recession. It can become difficult to fit dentures or implants when the jawbone has less density and has become more porous.
Osteoporosis and Gum Disease
Periodontal (gum) disease is another concern when people have osteoporosis. The loss of bone density in the jawbone can make it easier for bacteria to penetrate and affect the bone. This leads to gum disease. Consequences of gum disease include:
- Rapid bacteria penetration: Increased risk of periodontal disease makes it easier for bacteria to penetrate and affect the bone.
- Receding gums: As the jawbone loses density, the gums can recede because they have less to hold onto.
- Loose or lost teeth: When the jawbone is weakened, teeth can become loose or fall out.
- Dental implant issues: Dental implants require a strong jawbone to be successful and osteoporosis can weaken the bone so it can’t support the implants.
Medications for Osteoporosis and Their Effect on Oral Health
Several medications are prescribed to lessen bone loss when you have osteoporosis.
Bisphosphonates
Bisphosphonates are the primary medication for osteoporosis. They can be taken as a pill, liquid, or injection, and are typically taken on an empty stomach with water. Examples of bisphonates include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast).
There are possible side effects of taking bisphosphonate drugs, one of which is a rare complication that affects the jaw called osteonecrosis, which delays the healing of the jawbone after a dental procedure.
Hormone Therapy
Hormone therapies are also prescribed for osteoporosis, including estrogen or testosterone replacement, to help slow bone loss in women around menopause.
Other Medications
Other medications that may be prescribed in treating osteoporosis include parathyroid hormone (PTH) analogs, denosumab, and romosozumab, which are usually given as injections.
Possible Side Effects
There are possible side effects of taking bisphosphonate drugs as well as denosumab and romosozumab, one of which is a rare complication that affects the jaw called osteonecrosis. Though medication-related osteonecrosis of the jaw (MRONJ) is rare, it is a very serious condition where the jawbone can become exposed and not heal properly following dental procedures like extractions or implants; this is because both drugs inhibit bone resorption, making the jawbone more susceptible to damage and delayed healing.
Signs you may have MRONJ include persistent jaw pain, loose teeth, swelling in the jaw, exposed bone in the mouth, and difficulty eating.
Key points about denosumab and romosozumab’s impact on oral health:
- Increased risk of MRONJ: Both drugs are classified as having the potential to cause MRONJ, although the risk is considered low for most patients.
- Importance of dental consultation: Before starting either medication, it’s crucial to consult with a dentist to assess oral health and address any pre-existing dental issues.
- Careful dental procedures: If dental procedures are necessary while on these medications, dentists should take extra precautions to minimize the risk of complications.
Preventive Measures and Dental Care for People with Osteoporosis
If you have been diagnosed with osteoporosis or you are concerned you may have osteoporosis from a family genetic history and/or lifestyle issues, these are some actions you can take to prevent or possibly slow the progression of the disease:
- Regular Dental Checkups: It’s important to see a dentist regularly for early detection of oral health issues. A dentist can monitor bone density in the jaw through X-rays and tests to assess signs of periodontal disease.
- Maintaining Good Oral Hygiene: Keep a routine oral care regimen of brushing two times each day, flossing at least once, and using mouthwash. Manage dry mouth, which can be a side effect of osteoporosis medications, by drinking plenty of water and using a mouthwash designed for dry mouth.
- Dietary Considerations: Increase consumption of foods that support bone health. Foods that are rich in calcium and vitamin D are helpful in maintaining good nutrition that benefits both bone and oral health.
How Osteoporosis Affects Dental Treatments and Restorative Options
Osteoporosis can directly affect dental procedures and restorative options in several ways. Because the disease reduces bone density, dental implants are less stable and more likely to fail. A reduction in the volume of the jawbone makes it unable to support a dental implant. Healing time may be slowed if you are taking medication to treat osteoporosis like bisphosphonates. Additionally, you are more likely to fracture bones during or after implant surgery.
For patients who have osteoporosis, there are alternatives to dental implants such as dentures and bridges. However, osteoporosis may affect the stability and longevity of dental restorations, including crowns. Sometimes bone grafting procedures, which are common, may be required to strengthen the implants. A ridge expansion is another surgical option that can widen the jawbone to support dental implants. With proper planning and care, people with osteoporosis can have dental implants that are just as successful as those without osteoporosis.
The Importance of Communication Between Healthcare Providers
This is an example where communication between healthcare providers to ensure the safety of and best treatment for the patient is critical. It’s essential for both your dentist and doctor to be aware of your osteoporosis diagnosis since collaboration can help with more tailored treatment plans and preventive care. Be sure to inform your dentist and physician about your osteoporosis treatment regimen.
Effective communication between healthcare professionals has these benefits:
- Patient safety: When healthcare professionals communicate well, they can reduce the risk of errors and improve patient safety.
- Continuity of care: A communication plan that keeps everyone informed can ensure that patients receive consistent care.
- Teamwork: Good communication can help healthcare teams work together to overcome challenges and navigate competing priorities.
- Patient satisfaction: Clear communication can improve patient satisfaction.
Research and Future Directions
Research is ongoing currently so there is more data to support prevention, treatments, and the connection between osteoporosis and oral health. Researchers are investigating the biological pathways that connect systemic bone loss to changes in the jawbone, including inflammatory processes. Promising studies regarding bone regeneration or treatments to prevent jawbone loss are optimistic.
Future research may make early detection easier in identifying specific oral health markers that could predict the presence of osteoporosis and vice versa. And, finally, data may lead to better management strategies for ONJ by developing preventive measures and treatment options for patients with osteoporosis who require dental procedures, including medication adjustments and surgical techniques.
Conclusion
In conclusion, osteoporosis has a strong connection with oral health. The loss of bone directly relates to tooth loss, gum disease, and the success of dental surgeries. The importance of early intervention, preventive care, and regular dental visits can’t be stressed enough. Managing osteoporosis to protect bone health and oral health through diet, medication, exercise, and lifestyle will all contribute to positive outcomes.
Remember to minimize dental problems, you can:
- Maintain good oral hygiene
- Get regular dental check-ups
- Eat a healthy, well-balanced diet
- Get enough calcium and vitamin D
- Do regular weight-bearing exercises
- Stop smoking
- Reduce your alcohol and caffeine intake
Contact Sninski & Schmitt Family Dentistry to Schedule your Appointment for Routine Dental Care
Our professional team at Sninski & Schmitt Family Dentistry is ready to help with your dental care. Contact us for your dental checkup and cleaning. Call us at our Holly Springs dentist office at (919) 600-6262 and our Cary, NC dentist office at 919-467-2203, or fill out our contact form to schedule an appointment.