Periodontal Disease and Osteoporosis

Periodontal disease is characterized by a progressive loss of supportive gingival tissue in the gums and jawbone.  It is the number one cause of tooth loss among adults in the developed world.  Periodontal disease occurs when toxins found in oral plaque inflame and irritate the soft tissues surrounding the teeth.  If left untreated, bacteria colonies initially cause the systematic destruction of gum tissue, and then proceed to destroy the underlying bone tissue.

Osteoporosis is a common metabolic bone disease which frequently occurs in postmenopausal women, and occurs less frequently in men.  Osteoporosis is characterized by bone fragility, low bone mass and a decrease in bone mineral density.  Many studies have explored and identified a connection between periodontal disease and osteoporosis.

A study conducted at the University of New York at Buffalo in 1995 concluded that post-menopausal women who suffered from osteoporosis were 86% more likely to also develop periodontal disease.

Reasons for the Connection

Though studies are still being conducted in order to further assess the extent of the relationship between osteoporosis and periodontal disease, the researchers have thus far made the following connections:

• Estrogen deficiency – Estrogen deficiency accompanies menopause and also speeds up the progression of oral bone loss.  The lack of estrogen accelerates the rate of attachment loss (fibers and tissues which keep the teeth stable are destroyed).
  
  
• Low mineral bone density – This is thought to be one of several causes of osteoporosis, and the inflammation from periodontal disease makes weakened bones more prone to break down.  This is why periodontitis can be more progressive in patients with osteoporosis.

Diagnosis and Treatment

Osteoporosis and periodontal disease are much less dangerous if they are diagnosed in the early stages.  Once a diagnosis has been made, the dentist will generally work with the patient’s doctor to ensure that both diseases are effectively controlled.

Here are some methods commonly used to diagnose and treat the diseases:

• Routine dental X-rays – X-rays can be effectively used to screen for bone loss in the upper and lower jaw, and the dentist can provide interventions for preventing and treating periodontal disease.  It is believed that minimizing periodontal disease will help treat osteoporosis.
  
  
• Estrogen supplements – Providing post-menopausal women with estrogen supplements lowers the rate of attachment loss and also lowers gingival inflammation, which in turn protects the teeth from periodontal disease.
  
  
• Assessment of risk factors – Dentists and doctors are able to closely monitor the patients that are at an increased risk of developing both diseases by assessing family history, medical history, X-ray results, current medications and modifiable risk factors.  Tobacco use, obesity, poor diet and estrogen deficiency can all be managed using a combination of education, support and prescription medications.

If you have any questions about periodontal disease and its connection with osteoporosis, please contact our practice.

Periodontal disease (also called periodontitis and gum disease) has been linked to respiratory disease through recent research studies.  Researchers have concluded that periodontal disease can worsen conditions such as chronic obstructive pulmonary disease (COPD) and may actually play a causal role in the contraction of pneumonia, bronchitis and emphysema.

Periodontal disease is a progressive condition which generally begins with a bacterial infection.  The bacteria found in plaque begin to colonize in gingival tissue, causing an inflammatory response in which the body destroys both gum and bone tissue.  The sufferer may notice the teeth “lengthening” as the gums recede while the disease progresses.  If left untreated, erosion of the bone tissue brings about a less stable base for the teeth, meaning loose, shifting or complete tooth loss.

There are a number of different respiratory diseases linked to periodontal disease.  Pneumonia, COPD, and bronchitis are among the most common.  Generally, bacterial respiratory infections occur due to the inhalation of fine droplets from the mouth into the lungs. COPD is a leading cause of death and should be taken very seriously.

Reasons for the Connection

The fact that respiratory disease and periodontal disease are linked may seem far-fetched, but there is plenty of evidence to support it.

Here are some of the reasons for the link between periodontal disease and respiratory disease:

• Bacterial spread – The specific type of oral bacterium that causes periodontal disease can easily be drawn into the lower respiratory tract.  Once the bacteria colonize in the lungs, it can cause pneumonia and exacerbate serious conditions such as COPD.
  
  
• Low immunity – It has been well-documented that most people who experience chronic or persistent respiratory problems suffer from low immunity.  This low immunity allows oral bacteria to embed itself above and below the gum line without being challenged by the body’s immune system.  Not only does this accelerate the progression of periodontal disease, it also puts the sufferer at increased risk of developing emphysema, pneumonia and COPD.
  
  
• Modifiable factors – Smoking is thought to be the leading cause of COPD and other chronic respiratory conditions.  Tobacco use also damages the gingiva and compromises the good health of the oral cavity in its entirety.  Tobacco use slows the healing process, causes gum pockets to grow deeper and also accelerates attachment loss.  Smoking is not the sole cause of periodontal disease, but it is certainly a cofactor to avoid.
  
  
• Inflammation – Periodontal disease causes the inflammation and irritation of oral tissue.  It is possible that the oral bacteria causing the irritation could contribute to inflammation of the lung lining, thus limiting the amount of air that can freely pass to and from the lungs.

Diagnosis and Treatment

When respiratory disease and periodontal disease are both diagnosed in one individual, it is important for the dentist and doctor to function as a team to control both conditions.  There are many non-surgical and surgical options available, depending on the specific condition of the teeth, gums and jaw.

The dentist is able to assess the extent of the inflammation and tissue loss and can treat the bacterial infection easily.  Scaling procedures cleanse the pockets of debris and root planing smoothes the tooth root to eliminate any remaining bacteria.  The dentist generally places antibiotics into the pockets after cleaning to promote good healing and reduce the risk of the infection returning.

Whichever treatment is deemed the most suitable, the benefits of controlling periodontal disease are two-fold.  Firstly, any discomfort in the oral region will be reduced and the gums will be much healthier.  Secondly, the frequent, unpleasant respiratory infections associated with COPD and other common respiratory problems will reduce in number.

If you have questions or concerns about respiratory disease or periodontal disease, please ask your dentist.