Patient Information

Oral Bone Health Care

Is there any connection between osteoporosis and dental problems?

Studies have shown that women with osteoporosis or low bone density may have more oral bone loss, more periodontal disease (inflammation and infection of the gums and bone around the teeth), and more tooth loss than women with normal bone density. These are all common problems in the elderly, and the relationship among these disorders is complex. If you have osteoporosis, it is a good idea to see a dentist for regular checkups, and if you have persistent problems with dental health, consider getting a bone density test to see if you have osteoporosis.

Does the treatment of periodontitis improve the health of jaw bones?

Periodontitis is associated with bacterial infection and inflammation that releases chemicals called prostaglandins and cytokines. These, in turn, stimulate the activity of osteoclast cells that resorb, or dissolve bone. The result can be loss of bone in the jaw, which may eventually cause loosening and loss of teeth. The treatment of periodontitis is usually directed toward controlling plaque bacteria with dental procedures, antiseptics, and antibiotics. With fewer bacteria, there are lower levels of prostaglandins and cytokines, and hopefully stronger bone in the jaw. This may result in better attachment of teeth and less tooth loss.

Does the treatment of osteoporosis improve dental health?

Some research studies in animals and humans have shown that drugs used for the prevention or treatment of osteoporosis, such as estrogen and alendronate, may improve the health of periodontal tissue and decrease tooth loss.

Can the treatment of osteoporosis cause any harm to the jaw?

A rare but serious problem called “osteonecrosis of the jaw” (ONJ) has been reported in some patients who have received bisphosphonate drugs, such as pamidronate, zoledronate, alendronate, and risedronate. Most of these cases were in severely ill cancer patients taking multiple medications and being given high doses of a bisphosphonate by injection to treat cancer-related problems. However, a few cases of ONJ have been seen in patients being treated for osteoporosis with bisphosphonates given by mouth. ONJ typically is recognized when there is delay or failure of healing of the lower jaw after a dental procedure or tooth extraction. The cause of ONJ is unknown, but may be due to poor circulation in the bone, oversuppression of bone turnover (lowering of the rate of bone metabolism), or infection (osteomyelitis). Treatment is usually managed by an oral surgeon. If oral surgery or tooth extraction is anticipated, it may be best to do this before starting treatment with a bisphosphonate, especially one that is given by injection.

E. Michael Lewiecki, MD                                    
Lance A. Rudolph, MD

This page update 01/10/08