How Osteoporosis Affects Oral Health - savina dental clinics malta and gozo

Osteoporosis is one of the most underestimated health conditions affecting millions of people around the globe. It is a health condition commonly diagnosed pretty late in its progression, making it more difficult to reverse or offset the damage caused. This guide will look at how osteoporosis affects oral health.

What is osteoporosis?

Osteoporosis is a condition that causes bones to become brittle and weak, especially as someone ages. This weakening is progressive; in some cases, it can be so severe that even mild stress on limbs and other body areas caused by such benign actions as coughing or bending can lead to fractures.

The term osteoporosis is derived from two Greek words: osteo, meaning ‘of the bone’, and porosis meaning ‘porosity’. This is because osteoporosis results from bone density loss, increasing the spaces between bone cells.

Osteoporosis should not be confused with another bone condition called osteonecrosis. The Greek prefix necro denotes ‘death of’, meaning osteonecrosis results from the death of bone tissue, not just loss of its density.

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Oral symptoms of osteoporosis

Here are some symptoms that are often indicators that one is affected by osteoporosis

  • Persistent pain and swelling of the jaw, even when the teeth do not have cavities
  • Injured gums that don’t respond to regular treatment of the fleshy gum tissue
  • Loose teeth
  • A feeling of heaviness or numbness in the jaw
  • Bone tissue getting exposed through the gum

If you develop any of these symptoms, especially after tooth extraction or treatment of the gum and jaw, you should consult your dentist immediately.

Risk factors associated with osteoporosis

Some people have a higher risk of osteoporosis due to genetic factors, nutrition, and general health status. Women are more at risk than men, as explained in the section on osteoporosis in women below. The other risk factors for developing osteoporosis include:

Unhealthy lifestyle habits such as;

  • Smoking
  • Excessive alcohol consumption
  • Sedentary lifestyle with little or no physical exercise
  • Poor nutrition, including inadequate intake of calcium and vitamin D
  • Malabsorption of essential nutrients in the body caused by conditions such as Coeliac disease
  • Living with a chronic condition such as rheumatoid arthritis or hepatitis C
  • Immobility or paralysis which rules out such physical activity as walking
  • Hyperthyroidism, especially when the patient has to take a lot of thyroid hormone medication

Osteoporosis and temporomandibular disorders

Temporomandibular disorders (TMDs) affect the temporomandibular joints, jaw muscles, and associated muscles, often leading to chronic pain. Clinical research has shown that loss of bone mass due to osteoporosis can lead to an increased risk of developing TMDs.

Osteoporosis and periodontal disease

Clinicians classify both osteoporosis and periodontal disease as resorptive diseases. Resorptive diseases are those that lead to loss of bone mass. Periodontal disease, also known as periodontitis, is characterized by the resorption of alveolar bone. It is reputed to be the leading cause of tooth loss in adults.

Osteoporosis and dental prosthesis

Advanced osteoporosis may hinder fitting patients with new dentures or dental prostheses. Older patients who can’t be fitted with a functional dental prosthesis may experience severe nutritional deficiencies. Ill-fitting dentures can also cause oral sores and make it very hard for the patient to speak.

Osteoporosis and tooth loss

Osteoporosis has been shown to greatly increase the risk of tooth loss. In women, those with osteoporosis are about three times more likely to lose teeth than those who do not have the disease. Clinical studies have shown that post-menopausal women put on hormonal therapy have a far lower risk of tooth loss than those not receiving such treatment.

Osteoporosis in women

Osteoporosis is a disease that disproportionately affects more women than men. Estimates show that about one in every three women above the age of 65 suffers from osteoporosis.

The demographic class with the highest risk of developing osteoporosis is post-menopausal women. The drastic fall in these women’s reproductive hormone oestrogen levels leads to a progressive loss in bone mass and thus osteoporosis.

Younger women who become excessively thin due to eating disorders are also at a high risk of developing osteoporosis. This is because their bodies cannot satisfy their requirement of oestrogen necessary for healthy, strong bones.

Effects of osteoporosis medications on oral health

Medication used to manage and reverse the effects of osteoporosis includes substances known as antiresorptive agents. Antiresorptive agents have been shown to potentially lead to osteonecrosis of the jaw.

Limiting osteoporosis oral health effects

Limiting osteoporosis oral health effects - savina dental clinics malta

To limit osteoporosis’s effect on oral health, you should always keep your dentist appraised on any treatment regimen you are undergoing to manage osteoporosis. Here are other recommendations to follow to limit osteoporosis from having an adverse effect on your oral health.

Regular dental appointments

Making regular visits to your dentist is essential for your oral health. You should keep your dental appointments even when there are no apparent issues for the dentist to address. When your dentist identifies problems early, there is a greater likelihood of a positive outcome with the proper treatment, minimizing the need for extractions.

Exercising

Regular and adequate physical exercise will strengthen your bones while keeping away other adverse health conditions that could trigger or exacerbate your osteoporosis. If you already have osteoporosis, you should consult your physician on which physical activities are suitable to prevent you from placing too much pressure on your already fragile bones.

Healthy diet

A healthy and balanced diet is crucial for the health of your bones and teeth. You should consume adequate foods with a healthy supply of nutrients like calcium and Vitamin D. A balanced diet is essential for those living with osteoporosis to minimize any adverse effects of the condition on their general health.

Quitting smoking

Smoking is harmful to your bone strength and compactness. At an advanced age, smokers’ risk of developing osteoporosis increases manifold. Those who quit smoking have been shown to enjoy a marked increase in bone density, often in days and weeks from when they stopped smoking.

Quitting alcohol

There is nothing inherently harmful about taking moderate amounts of alcohol occasionally. But excessive consumption of alcohol can result in osteoporosis. Moreover, even a relatively average intake of alcohol can cause severe complications for those who already have the condition.

There is a clear link between osteoporosis and dental health. Individuals with osteoporosis or related bone conditions such as osteonecrosis are more likely to experience tooth loss and other dental issues. In particular, those most at risk (post-menopausal women) should take active measures as recommended above to manage the adverse effects of osteoporosis on oral health.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at its disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.