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Overview
According to a new study from the University at Buffalo  ,1 postmenopausal women infected with four species of periodontal bacteria were more likely to have oral bone loss, even after adjusting for smoking, age, and income. The study, available in the June 2007 Journal of Periodontology , was featured in online news articles from United Press International,2,3 Medical News Today ,4 and other agencies.
For the cross-sectional study, 1,256 postmenopausal women were recruited from the Buffalo, New York Women's Health Initiative Observational Study, and all were between 53 and 83 years of age. The researchers took plaque samples to evaluate the prevalence of eight subgingival bacterial species, including recognized periodontal pathogens (e.g., P. gingivalis and T. forsythensis) and control species such as S. sanguis. The research team also used dental radiographs to measure oral bone loss, using alveolar crestal height as a composite endpoint to assess potential associations between the presence of bacterial infection and oral bone loss.
In this analysis of oral health and osteoporosis, the researchers found that women infected with four major periodontal species—P. gingivalis, T. forsythensis, P. intermedia, and C. rectus—were more likely to have oral bone loss. Two primary etiological agents of periodontal disease, T. forsythensis and P. gingivalis, were identified in 38 percent and 15 percent of the study participants. By comparison, the control bacterial species S. sanguis was not associated with oral bone loss in the study population, and was more prevalent among healthy women than among those with severe oral bone loss. The research team also suggested that body mass index (BMI) may be a potential modifier of the association between periodontal bacteria and oral bone loss, since overweight women with T. forsythensis infection were found to be more likely to have oral bone loss.
Osteoporosis is a common metabolic bone disease characterized by low bone mass and fragility, especially for postmenopausal women. Although the condition affects women primarily, it also occurs in men and is commonly associated with a decrease in bone mineral density. The study supports the findings of previous research that identified an association between post-menopausal osteoporosis and tooth loss, along with alveolar bone loss.5,6 Based on current estimates, over 10 million Americans over the age of 50 have osteoporosis, and nearly 34 million individuals are at risk. In addition, over 1 million bone fractures each year are associated with osteoporosis.
As explained in the ADA monograph Women’s Oral Health Issues , a growing body of evidence has suggested a potential association between periodontal disease and osteoporosis, but the extent of this relationship remains unclear. Periodontal disease and oral bone loss can progress over time, and further population-based studies are needed to develop an improved understanding of the relationship between osteoporosis, periodontal disease and oral bone loss. The University at Buffalo researchers also recommend longitudinal studies on the association between body mass index, bacterial infection, and alveolar crest height.
Dentists and patients should be aware that osteoporosis has several modifiable risk factors, including smoking, inadequate dietary calcium and estrogen deficiency. While dentists closely monitor the periodontal health and oral bone loss in their patients, continuing research is necessary to identify patients at the highest risk for oral bone loss, and may also lead to more accurate screening and diagnostic methods. Dentists are encouraged to refer patients suspected of being at risk for osteoporosis—based on medical history, including risk factors, and results of clinical and X-ray examination—to their primary-care physician for a complete health assessment.
Footnotes
1Brennan RM, Genco RJ, Wilding GE, Hovey KM, Trevisan M, Wactawski-Wende J. Bacterial species in subgingival plaque and oral bone loss in postmenopausal women. J Perio 2007; 78(6):1051-61. Abstract available at: “http://www.ncbi.nlm.nih.gov/sites/entrez
?Db=pubmed
&Cmd=ShowDetailView&TermToSearch=17539719&ordinalpos=1&itool=
EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum ”.
Accessed June 19, 2007.
2 Oral bacteria linked to oral bone loss. United Press International, June 18, 2007. Available at: “http://www.upi.com/Consumer_Health_Daily/Briefing/ 2007/06/18/oral_bacteria_
linked_to_oral_bone_loss/3624/ ”.
Accessed June 19, 2007.
3 Gum disease possible at any age in women. United Press International, June 14, 2007. Available at: “http://www.thenewsroom.com/details/406048/Health ”.
Accessed June 19, 2007.
4 Gum disease in postmenopausal women linked to oral bone loss. Medical News Today, June 20, 2007. Available at: "http://www.medicalnewstoday.com/medicalnews.php?newsid
=74500 .”
Accessed, June 21, 2007.
5 Jeffcoat MK, Chesnut CH. Systemic osteoporosis and oral bone loss: evidence shows increased risk factors. JADA 1993 Nov;124(11):49-56.
6 Payne JB, Reinhardt RA, Nummikoski PV, Patil KD. Longitudinal alveolar bone loss in postmenopausal osteoporotic/osteopenic women. Osteoporos Int. 1999;10(1):34-40. Abstract available at: “http://www.ncbi.nlm.nih.gov/sites/entrez?cmd= retrieve&db=pubmed&
list_uids=10501777&dopt=Abstract ”.
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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Document Posted June 2007
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