Osteoporosis and its relation to oral health

Osteoporosis is a disease that affects the bones, making them more delicate and prone to fractures as it causes loss of bone mass and gradually weakens their internal structure. It is quite common, especially in older women, given the reduction of estrogen experienced after menopause. Other people are more at risk due to their genetics, although habits such as low calcium intake, smoking, drinking alcohol or not exercising also play a role.

Although it is often associated with fractures in large bones, such as those in the legs or spine, effects have also been observed in the mouth, which can trigger various oral problems.

Oral alterations in patients with osteoporosis

Several recent studies have investigated how osteoporosis affects the mouth, mainly in the jaw and upper jaw, which are the most vulnerable areas. In fact, these problems could be an early sign that the patient has osteoporosis in other parts of the body. This bone loss in the jaw happens when the trabecular bones, which are spongier and lighter as well as active in the bone renewal process, lose density.

Alveolar ridge resorption

The alveolar ridge is the bone that surrounds and supports the roots of the teeth. Osteoporosis alters the balance between the process of bone destruction and the formation of new bone, known as bone remodeling, affecting the way teeth function. As the bone loses mass, it becomes unable to support the teeth and thus facilitates their movement and subsequent fall.

Decreased maxillary bone density

As we were saying, patients diagnosed with osteoporosis have less bone density in the jaws, so there is a greater risk of them breaking. This also affects certain dental treatments, as it can make it more difficult to place dentures or implants. The bone is not strong enough to support them and, since this limits the options for restoring teeth, it directly affects patients' quality of life.

Periodontitis

Both osteoporosis and periodontitis share certain risk factors, such as smoking, lack of vitamin D or advanced age. Although osteoporosis is related to the loss of the bone that supports the teeth, this fact makes them more vulnerable to infections, so it can accelerate the appearance of periodontitis if there is a lack of good dental hygiene and the presence of bacterial plaque, or aggravate this condition if it already exists.

Edentulism

Edentulism is the medical term for tooth loss. As mentioned above, patients with osteoporosis are more likely to lose teeth(2.4 times more) compared to a person without this disease. However, there are also other factors that can have an influence, such as dental trauma, problems in the nerves of the teeth or problems with dental prostheses. Osteoporosis would act by accelerating the loss process.

Impact on nutrition

Although osteoporosis does not directly cause malnutrition, it can trigger a number of oral complications that may cause difficulty chewing food or inability to wear dentures. Not chewing well can lead to not enjoying a balanced diet. Nutritious foods such as fruits, vegetables and proteins may be more difficult to consume. This, in turn, can affect the patient's overall health.

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Effects of osteoporosis treatment on the oral cavity

Osteoporosis treatment often includes medications such as bisphosphonates that may have some effects on patients' oral health. On the one hand, bisphosphonates help prevent bone loss throughout the body and sometimes increase bone density. However, other complications can also develop that dentists should pay special attention to.

Osteonecrosis of the jaw

One of the effects of bisphosphonates is to inhibit bone resorption. In the case of a person who is under such treatment and must undergo dental surgery, it is important to bring it to the attention of your physician and dentist because if it is not controlled it can cause a problem called osteonecrosis of the jaw. This condition occurs when the jaw bone does not receive enough blood, leading to the death of bone tissue due to lack of nutrients and oxygen. All of this affects the ability to eat, speak and make certain movements with the mouth. It can also lead to oral infections that are difficult to treat because of the damage to the bone tissue.

In cases of osteoporosis, oral health specialists must make much more detailed evaluations before performing any procedures on patients taking these medications or directly suffering from this condition. They usually combine different diagnostic tools, such as panoramic radiographs, in which indicators such as the Panoramic Mandibular Index (PMI) and the Cortical Mandibular Index (CMI) are applied in order to calculate the density and degree of bone loss.

Once diagnosed, it is important to follow the advice of dentists and make regular visits to the dental clinic for check-ups or for specific treatments. Depending on the case, dentists may choose to delay certain treatments until patients stop taking medication for a period of time.