Osteoporosis and tooth loss are major health problems in postmenopausal women in a fast-aging country. In this study, we investigated the relationship between low bone mineral density (BMD) and edentulism.
Methods:
Data for this cross-sectional study were obtained from the fifth Korean National Health and Nutrition Examination Survey 2011–2012. BMD was measured, and a dental examination was performed on the 2,129 postmenopausal (50–80 years) female participants. Multivariate logistic regression through complex sampling was used to estimate the odds ratio (OR) for osteopenia and osteoporosis in women with loss of at least eight teeth.
Results:
The average number of missing teeth was significantly lower in women with a normal BMD than in those with osteopenia and osteoporosis (4.5 ± 0.4 vs. 6.7 ± 0.3 vs. 10.4 ± 0.5; p < 0.001). Women with abnormal BMD of the femoral neck were at higher risk of losing eight or more teeth than women with a normal BMD in the femoral neck (OR, 2.37; 95% confidence interval [CI], 1.88–2.99). Women with osteoporosis in the lumbar spine were also at a higher risk of losing eight or more teeth [OR, 1.89; 95% CI, 1.52–2.36] than were women with a normal BMD in the lumbar spine.
Conclusions:
Excessive edentulism might be associated with low BMD in postmenopausal women. Regular dental examination is recommended for the postmenopausal women with osteopenia or osteoporosis to prevent tooth loss.
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References
1.
GielenE, VanderschuerenD, CallewaertF, BoonenS. Osteoporosis in men. Best Pract Res Clin Endocrinol Metab, 2011; 25:321–335.
2.
Melton LJ 3rd. Who has osteoporosis? A conflict between clinical and public health perspectives. J Bone Miner Res, 2000; 15:2309–2314.
3.
ZhaoR. Immune regulation of osteoclast function in postmenopausal osteoporosis: A critical interdisciplinary perspective. Int J Med Sci, 2012; 9:825–832.
4.
LeeY, YoonB, KooK. Epidemiology of osteoporosis and osteoporotic fractures in South Korea. Endocrinol Metab, 2013; 28:90–93.
5.
MarcenesW, Kasseabaum, BarnableE, et al.Global Burden of oral conditions in 1990–2010: A systematic analysis. J Dent Res, 2013; 92:592–597.
6.
LacerdaJT, CastilhoEA, CalvoMCM, FreitasSFT. Oral health and daily performance in adults in Chapeco, Santa Catarina, Brazil. Cad Saude Publica, 2008; 24:1846–1858.
7.
LockerD, QuinonezC. Functional and psychosocial impacts of oral disorders in Canadian adults: A national population survey. J Can Dent Assoc, 2009; 75:521a–e.
8.
ShimazakiY, SohI, SaitoT, et al.Influence of dentition status on physical disability, mental impairment, and mortality in institutionalized elderly people. J Dent Res, 2001; 80:340–345.
9.
MoritaM, KimuraT, KanegaeM, IshikawaA, WatanabeT. Reasons for extraction of permanent teeth in Japan. Commun Dent Oral Epidemiol, 1994; 22:303–306.
10.
KrallEA, Dawson-HughesB, PapasA, GarciaRI. Tooth loss and skeletal bone density in healthy postmenopausal women. Osteoporos Int, 1994; 4:104–109.
11.
BuencaminoMC, PalomoL, ThackerHL. How menopause affects oral health, and what we can do about it. Cleve Clin J Med, 2009; 76:467–475.
12.
MithalA, DhingraV, LauE. The Asian audit: Epidemiology, costs, and burden of osteoporosis in Asia 2009. [Brochure]. Nyon, Switzerland: International Osteoporosis Foundation.
13.
TaguchiA, FujiwaraS, MasunariN, SuzukiG. Self-reported number of remaining teeth is associated with bone mineral density of the femoral neck, but not of the spine, in Japanese men and women. Osteoporos Int, 2004; 15:842–846.
14.
TaguchiA, SueiY, OhtsukaM, TanimotoK, HollenderLG. Relationship between bone mineral density and tooth loss in elderly Japanese women. Dentomaxillofac Radiol, 1998; 28:219–223.
15.
JangKM, ChoKH, LeeSH, HanSB, HanKD, KimYH. Tooth loss and bone mineral density in postmenopausal South Korean women: The 2008–2010 Korea National Health and Nutrition Examination Survey. Maturitas, 2015; 82:360–364.
16.
KimCS, KimEK, LeeKS, et al.Relationship between bone mineral density, its associated physiological factors, and tooth loss in postmenopausal Korean women. BMC Women's Health, 2015; 15:65.
17.
SongHJ, LeeDH. Relationship between bone mineral density and the remaining teeth in Korean adults. J Korean Soc Dent Hyg, 2015; 15:63–71.
18.
Korea Centers for Disease Control and Prevention. The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). Seoul; 2013.
19.
YangYJ, KimJ. Factors in relation to bone mineral density in Korean middle-aged and older men: 2008–2010 Korea National Health and Nutrition Examination Survey. Ann Nutri Metab, 2014; 64:50–59.
20.
NittaH, IshikawaI. Skeletal and mandibular bone mineral density in dentate and edentulous postmenopausal women. Clin Calcium, 2003; 13:594–598.
21.
BandoK, NittaH, MatsubaraM, IshikawaI. Bone mineral density in periodontally healthy and edentulous postmenopausal women. Ann Periodontol, 1998; 3:322–326.
22.
JeffcoatMK, ReddyMS, DeCarloAA. Oral bone loss and systemic osteopenia. In MarcusR, FeldmanD, KelseyJ, eds. Osteoporosis. San Diego: Academic Press, 2001:363–384.
23.
Von WowernN. General and oral aspects of osteoporosis: A review. Clin Oral Investig, 2001; 5:71–82.
24.
TaguchiA, TanimotoK, SueiY, OhamaK, WadaT. Relationship between the mandibular and lumbar vertebral bone mineral density at different postmenopausal stages. Dentomaxillofac Radiol, 1996; 25:130–135.
25.
KribbsP, ChesnutC, OttS, KilcoyneR. Relationships between mandibular and skeletal bone in a population of normal women. J Prosthet Dent, 1990; 63:86–89.
26.
MischCE. Contemporary implant dentistry, 3rd ed. St. Louis: Mosby, 2008:131–132.
27.
StevensonJ, BanksL, SpinksT, et al.Regional and total skeletal measurements in the early postmenopause. J Clin Invest, 1987; 80:258–262.
28.
Von WowernN, KlausenB, KollerupG. Osteoporosis: A risk factor in periodontal disease. J Periodontol, 1994; 65:1134–1138.
29.
TezalM, Wactawski-WendeJ, GrossiSG, HoAW, DunfordR, GencoRJ. Relationship between bone mineral density and periodontitis in postmenopausal women. J Periodontol, 2000; 71:1492–1498.
30.
TakaishiY, OkamotoY, IkeoT, et al.Correlations between periodontitis and loss of mandibular bone in relation to systemic bone changes in postmenopausal Japanese women. Osteoporos Int, 2005; 16:1875–1882.
31.
LiP, HeL, ShaYQ, LuanQX. Relationship between metabolic syndrome to chronic periodontitis. J Periodontol, 2009; 80:541–549.
32.
RonderosM, JacobsDR, HimesJH, PihlstromBL. Associations of periodontal disease with femoral bone mineral density and estrogen replacement therapy: Cross-sectional evaluation of US adults from NHANES III. J Clin Periodontol, 2000; 27:778–786.
33.
DanielleHW. Postmenopausal tooth loss. Contributions to edentulism by osteoporosis and cigarette smoking. Arch Int Med, 1982; 143:1678–1682.
34.
GurA, NasK, KayhanO, et al.The relation between tooth loss and bone mass in postmenopausal osteoporotic women in Turkey. J Bone Miner Metab, 2003; 21:43–47.
35.
EarnshawSA, KeatingN, HoskingDJ, et al.Tooth counts do not predict bone mineral density in early postmenopausal Caucasian women. Int J Epidemiol, 1998; 27:479–483.
36.
MayH, ReaderR, MurphyS, KhawK. Self-reported tooth loss and bone mineral density in older men and women. Age Ageing, 1995; 10:217–221.
37.
MohammadAR, BauerRL, YehCK. Spinal bone density and tooth loss in a cohort of postmenopausal women. Int J Prosthodont, 1997; 10:381–385.
