A new study has strengthened the correlation between osteoporosis treatment and severe periodontitis in postmenopausal women.
During menopause, oestrogen levels fall at the same time as other substances that accelerate the bone remodelling cycle increase, activating osteoclasts (which break down old bone) and leading to greater bone resorption, weaker bones and increased risk of fracture. ‘Antiresorptive’ agents can be provided, many of which are hormone therapies that slow the activity of osteoclasts and stimulate osteoblasts (which build new bone).
Several studies suggest a link between osteoporosis treatments and increased periodontal health1,2,3,4,5,6,7,8,9 and Passos-Soares et al. have recently strengthened this hypothesis.
The study considered the health of 492 postmenopausal women between the ages of 50 and 87 years. 356 women were diagnosed with osteoporosis or osteopenia, of which 113 were currently receiving treatment (and 397 reported never having undergone treatment). In addition to the two main variables being evaluated, the authors assessed possible effects from other factors including personal and family income, schooling level, smoking habits, alcohol consumption, frequency of physical activity, visits to the dentist and use of dental floss.
The results found that individuals receiving osteoporosis treatment with oestrogen had smaller average measurements for probing depth, clinical attachment and bleeding on probing compared to the group without treatment. The rate of severe periodontitis was 44% lower in the osteoporosis treatment group than in the group without treatment, even after adjustments for co-variables.
How can we use these findings?
The possible association between osteoporosis treatment and periodontal disease can be used to tailor advice for patients. While we cannot influence whether they undergo hormone therapy, being aware of it and ensuring all clinical records are updated regularly will help us better understand each individual’s oral condition.
Furthermore, when caring for postmenopausal patients who are not receiving treatment for their osteoporosis, the study supports the key risk factors for poor periodontal health that we would look for – including smoking and oral hygiene habits. Improving home care routines is the first step towards better dental health for the vast majority of patients, so recommending the use of a Waterpik® Water Flosser, in addition to regular brushing, can be very effective when looking to help prevent periodontal disease in such a high risk group of patients.