Abstract
Associations between dental status and skeletal bone density were investigated in a group of 329 healthy postmenopausal women with normal bone density. Bone mineral density (BMD) of the lumbar spine, femoral neck and distal radius were measured by dual-or single-photon absorptiometry. Number of teeth remaining were counted and presence of complete dentures noted by a nurse practitioner. Forty-eight women (15%) wore a complete maxillary and/or mandibular denture: 22 (7%) were completely edentulous and an additional 26 (8%) had one edentulous ridge. Among women without complete dentures (n=281), significant positive linear relationships were observed between number of teeth and BMD at the spine (p<0.05) and radius (p<0.01), controlling for years since menopause, pack-years of smoking, education and body mass index. BMD did not differ between the groups with and without dentures. However, women who acquired dentures after the age of 40 years had significantly lower mean spinal and radial BMD than women who acquired dentures at age 40 years or earlier (at the radius, 0.584±0.015 v 0.630±0.017 g/cm2,p<0.05; at the spine, 1.043±0.031 v 1.124±0.029 g/cm2,p=0.05). In linear regression analysis, significant independent correlations were found among all women (n=329) between number of teeth and age (partialr=−0.19,p<0.001), pack-years of cigarette use (partialr=−0.23,p<0.001) and years of education (partialr=+0.11,p<0.05). These associations between dental status and BMD support the hypothesis that systemic bone loss may contribute to tooth loss.
Similar content being viewed by others
References
Bloom B, Gift HC, Jack SS. Dental services and oral health; United States, 1989. National Center for Health Statistics. Vital Health Stat 10 (183), 1992.
National Osteoporosis Foundation, Washington, DC, 1993.
Kribbs PJ, Chesnut CH, Ott SM, Kilcoyne RF. Relationships between mandibular and skeletal bone in an osteoporotic population. J Prosthet Dent 1989;62:703–7.
Elders PJM, Habets LLMH, Netelenbos JC, Van der Linden LWJ, Van der Stelt PF. The relation between periodontitis and systemic bone loss in women between 46 and 55 years of age. J Clin Periodontol 1992;19:492–6.
Daniell HW. Postmenopausal tooth loss: contributions to edentulism by osteoporosis and cigarette smoking. Arch Intern Med 1983;143:1678–82.
Daniell HW. Osteoporosis of the slender smoker. Arch Intern Med 1976;136:298–304.
Kribbs PJ. Comparison of mandibular bone in normal and osteoporotic women. J Prosthet Dent 1990;63:218–22.
Rosenquist JB, Baylink DJ, Berger JS. Alveolar atrophy and decreased skeletal mass of the radius. Int J Oral Surg 1978;7:479–81.
Bays RA, Weinstein RS. Systemic bone disease in patients with mandibular atrophy. J Oral Maxillofac Surg 1982;40:270–2.
Mercier P, Inoue S. Bone density and serum minerals in cases of residual alveolar ridge atrophy. J Prosthet Dent 1981;46:250–5.
Dawson-Hughes B, Dallal GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation of bone density in postmenopausal women. N Engl J Med 1990:323:878–83.
Shipp CC, Berger PS, Deehr MS, Dawson-Hughes B. Precision of dual-photon absorptiometry. Calcif Tiss Int 1988;42:287–92.
Dawson-Hughes B, Deehr MS, Berger PS, Dallal GE, Sadowski LJ. Correction of the effects of source, source strength, and soft-tissue thickness on spine dual-photon absorptiometry measurements. Calcif Tissue Int 1989;44:251–7.
Riggs BL, Melton LJ III. Involutional osteoporosis. N Engl J Med 1986;314:1676–86.
SAS Institute Inc. 1985 SAS user's guide: statistics, version 5. Cary, NC.
Ward VJ, Manson JD. Alveolar bone loss in periodontal disease and the metacarpal index. J Periodontol 1973;44:763–9.
Ward VJ, Stephens AP, Harrison A, Lurie D. The relationship between the metacarpal index and the rate of mandibular ridge resorption. J Oral Rehabil 1977;4:83–9.
Kribbs PJ, Smith DE, Chesnut CH. Oral findings in osteoporosis. II. Relationship between residual ridge and alveolar bone resorption and generalized skeletal osteopenia. J Prosthet Dent 1983;50:719–24.
Kribbs PJ, Chesnut CH, Ott SM, Kilcoyne RF. Relationships between mandibular and skeletal bone in a population of normal women. J Prosthet Dent 1990;63:86–9.
von Wowern N, Storm TL, Olgaard K. Bone mineral content by photon absorptiometry of the mandible compared with that of the forearm and the lumbar spine. Calcif Tiss Int 1988;42:157–61.
Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985;7:178–208.
Bergman JD, Wright FAC, Hammond RH. The oral health of the elderly in Melbourne. Austral Dent J 1991;36:280–5.
Kranzler HR, Babor TF, Goldstein L, Gold J. Dental pathology and alcohol-related indicators in an outpatient clinic sample. Comm Dent Oral Epidemiol 1990;18:204–7.
Stephens RG, Kogon SL, Jarvis AM. A study of the reasons for tooth extraction in a Canadian population sample. J Can Dent Assoc 1991;57:501–4.
Krook L, Lutwak L, Whalen JP, Henrikson P-A, Lesser GV, Uris R. Human periodontal disease: morphology and response to calcium therapy. Cornell Vet 1972;62:32–5.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Krall, E.A., Dawson-Hughes, B., Papas, A. et al. Tooth loss and skeletal bone density in healthy postmenopausal women. Osteoporosis Int 4, 104–109 (1994). https://doi.org/10.1007/BF01623233
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01623233