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Do patients with osteoporosis have an increased prevalence of periodontal disease? A cross-sectional study

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Abstract

Summary

The study examined if women with osteoporosis were at increased risk of periodontal disease. Three hundred eighty females aged 45–65 years with recent dual-energy X-ray absorptiometry (DXA) scans of the spine and proximal femur agreed to a dental examination. No association was established between the presence of severe periodontal disease and osteoporosis.

Introduction

The purpose of this study is to determine whether patients with osteoporosis have an increased severity and extent of periodontal disease, taking full account of confounding factors.

Methods

Volunteer dentate women (45–65 years), who had undergone recent DXA of the femur and lumbar spine, received a clinical examination of their periodontal tissues by a single trained operator who was blind to the subject's osteoporosis status. Clinical examinations were performed within 6 months of the DXA. Basic Periodontal Examination score, gingival bleeding score, periodontal pocket depth, recession and calculus were the periodontal outcome measures. Potential confounding factors were recorded. Logistic regression was performed for the dichotomous outcome measure of severe periodontal disease (present or absent) with osteoporotic status, adjusting for confounding factors.

Results

There were 380 dentate participants for whom DXA data were available. Of these, 98 had osteoporosis. When compared with osteoporotic subjects, those with normal bone mineral density were significantly younger (p = 0.01), had a higher body mass index (p = 0.03) and had more teeth (p = 0.01). The prevalence of severe periodontal disease in the sample was 39 %. The unadjusted odds ratio for the association between osteoporosis and severe periodontal disease was 1.21 (0.76 to 1.93). The adjusted odds ratio analysis including other covariates (age, smoking, hormone replacement therapy, alcohol) was 0.99 (0.61 to 1.61).

Conclusion

No association was established between the presence of severe periodontal disease and osteoporosis.

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References

  1. Locker D, Slade G, Murray H (1998) Disease among older adults: a review. Periodontol 6:16–33

    Article  Google Scholar 

  2. Papapanou PN (1999) Epidemiology of periodontal diseases: an update. J Int Acad Periodontol 1:110–116

    PubMed  CAS  Google Scholar 

  3. Department of Health (2005) Choosing better oral health: an oral health plan for England. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4123253.pdf

  4. Davis DM, Fiske J, Scott B, Radford DR (2000) The emotional effects of tooth loss: a preliminary quantitative study. BDJ 188:503–506

    PubMed  CAS  Google Scholar 

  5. Wactawski-Wende J (2001) Periodontal diseases and osteoporosis: association and mechanisms. Ann Periodontol 6:197–208

    Article  PubMed  CAS  Google Scholar 

  6. Chesnut CH 3rd (2001) The relationship between skeletal and oral bone mineral density: an overview. Ann Periodontol 6:193–196

    Article  PubMed  Google Scholar 

  7. Lerner UH (2006) Inflammation-induced bone remodeling in periodontal disease and the influence of post-menopausal osteoporosis. J Dent Res 85:596–607

    Article  PubMed  CAS  Google Scholar 

  8. Mundy GR (1999) Cellular and molecular regulation of bone turnover. Bone 24:35S–38S

    Article  PubMed  CAS  Google Scholar 

  9. Nicopoulou-Karayianni K, Tzoutzoukos P, Mitsea A et al (2009) Tooth loss and osteoporosis: the OSTEODENT study. J Clin Periodontol 36:190–197

    Article  PubMed  Google Scholar 

  10. Sultan N, Rao J (2011) Association between periodontal disease and bone mineral density in post-menopausal women: a cross sectional study. Med Oral Patol Oral Cir Bucal 16:e440–e447

    Article  PubMed  Google Scholar 

  11. Payne JB, Reinhardt RA, Nummikoski PV, Patil KD (1999) Longitudinal alveolar bone loss in postmenopausal osteoporotic/osteopenic women. Osteoporos Int 10:34–40

    Article  PubMed  CAS  Google Scholar 

  12. Tezal M, Wactawski-Wende J, Grossi SG, Ho AW, Dunford R, Genco RJ (2000) The relationship between bone mineral density and periodontitis in postmenopausal women. J Periodontol 71:1492–1498

    Article  PubMed  CAS  Google Scholar 

  13. Yoshihara A, Seida Y, Hanada N, Miyazaki H (2004) A longitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults. J Clini Periodontol 31:680–684

    Article  Google Scholar 

  14. Inagaki K, Kurosu Y, Kamiya T, Kondo F, Yoshinari N, Noguchi T, Krall EA, Garcia RI (2001) Low metacarpal bone density, tooth loss, and periodontal disease in Japanese women. J Dent Res 80:1818–1822

    Article  PubMed  CAS  Google Scholar 

  15. Megson E, Kapellas K, Bartold PM (2010) Relationship between periodontal disease and osteoporosis. Int J Evid-Based Healthc 8:129–139

    Article  PubMed  Google Scholar 

  16. Greene J, Vermillion J (1960) The oral hygiene index: a method for classifying oral hygiene status. J Amer Dent Ass 61:29–35

    Google Scholar 

  17. Pearson J, Dequeker J, Reeve J et al (1995) Dual X-ray absorptiometry of the proximal femur: normal European values standardized with the European Spine Phantom. J Bone Miner Res 10:315–324

    Article  PubMed  CAS  Google Scholar 

  18. Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Johnston CC, Lindsay R (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489

    Article  PubMed  CAS  Google Scholar 

  19. Locker D, Slade GD, Murray H (1998) Epidemiology of periodontal disease among older adults: a review. Periodontol 16:16–33

    Article  CAS  Google Scholar 

  20. Jeffcoat MK, Lewis CE, Reddy MS, Wang CY, Redford M (2000) Post-menopausal bone loss and its relationship to oral bone loss. Periodontol 23:94–102

    Article  CAS  Google Scholar 

  21. Kribbs PJ, Chesnut CH 3rd, Ott SM, Kilcoyne RF (1989) Relationships between mandibular and skeletal bone in an osteoporotic population. J Prosthet Dent 62:703–707

    Article  PubMed  CAS  Google Scholar 

  22. Gomes-Filho IS, Passos Jde S, Cruz SS et al (2007) The association between postmenopausal osteoporosis and periodontal disease. J Periodontol 78:1731–1740

    Article  PubMed  Google Scholar 

  23. Passos Jde S, Gomes-Filho IS, Vianna MI, da Cruz SS, Barreto ML, Oliveira TJ, Borges LD, Monteiro FM (2010) Outcome measurements in studies on the association between osteoporosis and periodontal disease. J Periodontol 81:1773–1780

    Article  PubMed  Google Scholar 

  24. Brennan-Calanan RM, Genco RJ, Wilding GE, Hovey KM, Trevisan M, Wactawski-Wende J (2008) Osteoporosis and oral infection: independent risk factors for oral bone loss. J Dent Res 87:323–327

    Article  PubMed  CAS  Google Scholar 

  25. Reinhardt RA, Payne JB, Maze CA, Patil KD, Gallagher SJ, Mattson JS (1999) Influence of estrogen and osteopenia/osteoporosis on clinical periodontitis in postmenopausal women. J Periodontol 70:823–828

    Article  PubMed  CAS  Google Scholar 

  26. Famili P, Cauley J, Suzuki JB, Weyant R (2005) Longitudinal study of periodontal disease and edentulism with rates of bone loss in older women. J Periodontol 76:11–15

    Article  PubMed  CAS  Google Scholar 

  27. Moedano DE, Irigoyen ME, Borges-Yanez A, Flores-Sanchez I, Rotter RC (2011) Osteoporosis, the risk of vertebral fracture and periodontal disease in an elderly group in Mexico City. Gerodontology 28:19–27

    Article  PubMed  Google Scholar 

  28. Ronderos M, Jacobs DR, Himes JH, Pihlstrom BL (2000) Associations of periodontal disease with femoral bone mineral density and oestrogen replacement therapy: cross-sectional evaluation of US adults from NHANES III. J Clin Periodontol 27:778–786

    Article  PubMed  CAS  Google Scholar 

  29. Pilgram TK, Hildebolt CF, Dotson M, Sheldon CC, Hauser JF, Kardaris E, Civitelli R (2002) Relationships between clinical attachment level and spine and hip bone mineral density: data from healthy post-menopausal women. J Periodontol 73:298–301

    Article  PubMed  Google Scholar 

  30. Nunn J, Morris J, Pine C, Pitts NB, Bradnock G, Steele J (2000) The condition of teeth in the UK in 1998 and implications for the future. Br Dent J 189:639–644

    PubMed  CAS  Google Scholar 

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Acknowledgments

We are grateful to the National Osteoporosis Society, who supported this research through a project grant (120/126 (NOS-2006-19)).

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Correspondence to E. J. Marjanovic.

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Marjanovic, E.J., Southern, H.N., Coates, P. et al. Do patients with osteoporosis have an increased prevalence of periodontal disease? A cross-sectional study. Osteoporos Int 24, 1973–1979 (2013). https://doi.org/10.1007/s00198-012-2246-9

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  • DOI: https://doi.org/10.1007/s00198-012-2246-9

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