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Osteoporosis Not a Risk for Gum Disease
June 25, 2013

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Women with osteoporosis do not a higher risk of severe gum disease, a study concludes. The study was done in the United Kingdom. It included 380 women. All were between the ages of 45 and 65. They recently had imaging of the lower spine and thigh bone (femur). This type of imaging is used to diagnose osteoporosis, a chronic disease that weakens bones. Within 6 months of the imaging, women had dental exams. They were checked for signs of gum disease.

Of the women, 98 (26%) had osteoporosis. These women tended to be older than the others. On average, they also had fewer teeth and were less likely to be overweight.

Also, 148 of the women (39%) had severe gum (periodontal) disease.

Women with osteoporosis were not more likely to have severe gum disease. The researchers adjusted their numbers to take into account other factors that affect the risk of gum disease. They included age, smoking status, alcohol use and the use of hormone replacement therapy.

Women with periodontal disease had more tartar and plaque on their teeth than other women.

Periodontal disease and osteoporosis both become more common as people age. They also are more common in smokers. Both diseases lead to bone loss, but they differ in how this happens.

In periodontal disease, an infection turns on the body's immune system. This leads to inflammation. The body produces proteins called cytokines, which speed up bone breakdown. In osteoporosis, the loss of bone occurs because of lower levels of the hormone estrogen.

Some studies have found a link between low bone mineral density (a measure of bone loss) and periodontal disease. Others have not. At least four studies have found an increased risk of periodontal disease among women who are past menopause and have osteoporosis. However, the authors noted that studies often have different definitions of periodontal disease.

For example, one previously published study defined periodontal disease two different ways. It found no increased risk when periodontal disease was defined by the average clinical attachment loss (CAL). This measures how much the gums have pulled away from the teeth. There is a separate measure for each tooth. When the same study defined periodontal disease by the number of teeth with CAL greater than 4 millimeters, it did show an increased risk.

This study used a definition endorsed by the British Society of Periodontology. It says that a person with severe periodontal disease has at least one tooth with CAL greater than 5.5 millimeters.

The study used the World Health Organization's definition of osteoporosis. The authors noted that many other studies did not use this definition, or did not say how they defined osteoporosis.

The study appears in the July issue of the journal Osteoporosis International. It was published online in January.

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