The Tribune

By DR ANDRE CLARKE

Osteoporosis is a nice fancy word. We often hear about it in the media. Older men and women predominantly get it and many supplements claim to be able to stop it or slow it down.

Osteoporosis means porous bone, and is the thinning of bone tissue, along with the loss of bone density. In simple terms, the bone develops many holes and is more likely to break. It can affect any bone in the body, but most often affects the spine, hips and wrists. It is worth noting that over 40 million people in the US are directly affected by this disease. It is a health concern affecting many older individuals.

The jaws are not spared by osteoporosis. Osteoporosis can cause loose teeth, gum disease and periodontal (all the surrounding and supporting structures of the teeth) disease. There seems to be a direct relationship between the health of a person's bone and their mouth. Osteoporosis is unhealthy bone and leads to an unhealthy mouth. Research verifies this connection, and the unhealthy mouth is represented by bone loss in the jaw.

It is widely accepted that the bone in the jaws acts as the support that holds teeth in the mouth. When the bone is thinned and less dense, teeth can become loose. This is a common phenomenon occurring in more women than men, in the above 65 age group.

You may be wondering, "What about those persons above the 65 age group, who have already lost all their teeth?" The answer is this. There will be bone loss, as a result of osteoporosis, even with no teeth present. Therefore, if the individual wears dentures, the fit of the dentures will change, as the supporting bone underneath the gum, falls victim to osteoporosis. The dentures will invariably need to be adjusted, readjusted and maybe changed. How quickly the dentures need to be changed, depends on the rate of bone thinning in the jaws.

The connection between skeletal done density and periodontal disease is less clear than the connection between skeletal bone density and tooth loss. Some studies suggest a strong correlation and others do not. It is possible, that the loss of supporting tooth structure (bone loss) can increase susceptibility to gum disease forming bacteria. This susceptibility then increases the risk of gum disease and gum disease is known to cause tooth loss.

Knowledge about the connection between osteoporosis and the mouth is in perpetual evolution. There is research that is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) promoting the use of dental X-rays as an osteoporosis screening tool. This would be yet another avenue where dentists and medical doctors can work together to better manage their patients.

When a diagnosis of osteoporosis is made by the medical doctor, there are a number of management specifics that the doctor will explain to the patient. They usually include lifestyle modifications and the potential prescription of a class of drugs called the Bisphosphonates. The Bisphosphonates are considered safe drugs and indispensable in the treatment of osteoporosis, but one potential side effect is the development of osteonecrosis (bone death) of the jaw. The risk of developing osteoporosis is related to the dose, the quantity and the route of administration of the Bisphosphonates. The medical doctor and the dentist often work together to prevent and to manage (if it occurs) osteonecrosis.

Keeping bones healthy and strong can be achieved by healthy lifestyle choices. It is important to follow the advice of your healthcare team. Four important suggestions are as follows:

Eat a well-balanced diet and ensure the inclusion of calcium and vitamin D.

Participate in regular physical activity and exercise. Walking, jogging, dancing, and weight training are excellent options.

Do not smoke and limit your amount of alcohol intake.

Please tell your dentist about any problems with loose teeth, receding gums, and loose or ill-fitting dentures.

Our mouth, our health. Keep it alive.

This article is for informational purposes only. It is not intended and may not be treated as, a substitute for professional medical/dental advice, diagnosis, or treatment. Always seek the advice of a physician or dental professional with any questions you may have regarding a medical/dental condition. Never disregard professional medical/dental advice or delay in seeking it because of a purely informational publication.

If you have questions, please send email to dr_andreclarke@hotmail.com.