Can Your Dental Exam Reveal Osteoporosis?
As medical consumers, we love getting more than we bargained for. What if you could get screened for osteoporosis during a dental exam? In the near future, that just may be the case.
According to the National Osteoporosis Foundation, osteoporosis is a disease in which bones become fragile and more likely to break. If left untreated, osteoporosis can progress painlessly until a bone breaks, typically in the hip, spine, and wrist.
Approximately 10 million Americans currently have osteoporosis, while another 34 million have low bone mass and increased risk for osteoporosis. Nearly 80 percent of them are women, and many have no idea they're at risk. That's why research that enables dentists to screen for osteoporosis is so promising.
Researchers at the School of Dentistry, University of Manchester, have created a new way of identifying osteoporosis in patients. Software that detects osteoporosis during routine dental x-rays automatically measures the thickness of the patient's lower jaw. The study findings, published in the journal Bone, are based on x-rays of 652 European women aged 45 to 70. All women also underwent DEXA (dual energy x-ray absorptiometry scans), a traditional bone density test as well as panoramic dental X-rays, which show the whole jaw. The DEXA scans found osteoporosis in the hip or spine in 140 women. Analysis of dental X-rays picked up more than half of these cases.
The findings suggest that eventually, routine dental X-rays could provide an inexpensive way to screen older adults for osteoporosis. Those with bone thinning in the jaw could be referred for more expensive osteoporosis testing.
That's not the only connection between dental health and osteoporosis. According to the Journal of the American Dental Assocation, "A relationship between periodontitis and osteoporosis has been established, such that more clinical attachment loss has been noted in osteoporotic people." Clinical attachment refers to how well gums stick to teeth. With periodontitis, that healthy connection is lost. The reason why may be because of bone loss.
The National Institues of Health (NIH) estimates that periodontal disease affects up to 80 percent of Americans. Bacteria and the body's own immune system break down the bone and connective tissue that hold teeth in place. It is also possible that the loss of bone density leaves bone more susceptible to periodontal bacteria.
Recent news reports have drawn negative attention to oral biophosphonates, one of the medications used to treat osteoporosis. The drugs have been associated with osteonecrosis of the jaws (ONJ), a rare but potentially serious condition that can cause severe destruction of the jawbone. The American Dental Association reassures us that 94 percent of ONJ cases have been patients who received large doses of Intravenous bisphosphonates for cancer treatment. Only 6 percent have been associated with oral bisphosphonates, and researchers agree the risk of developing ONJ is very small.
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