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Effect of Osteoporosis on Oral Health

CM Marya and Chandan Dhingra

Osteoporosis, a generalized skeletal disease, has emerged as a major health problem affecting middle aged and older individuals. Osteoporosis is a grave social and economic problem for which the dentist has the opportunity to make unique contributions by early identification of patients with the potential for osteoporosis. The disease is associated with several risk factors, and increasing evidence suggests that it may be associated with oral health conditions such as periodontal disease, reduced jaw bone density, tooth loss, inability to create functional dentures and temporomandibular disorders. Women with osteoporosis are three times more likely to experience tooth loss than those who do not have the disease. Systemic loss of bone density in osteoporosis including that of the oral cavity may provide a host system that is increasingly susceptible to infectious destruction of periodontal tissue. Besides the effect of osteoporosis on oral health, bisphosphonate (BP) related osteonecrosis of jaws is a major concern to the dentist. The mandible is more commonly affected than the maxilla (2:1 ratio). Dental treatment seems to be a precipitating event in the development of most cases of BP related osteochemonecrosis. It is therefore imperative that osteoporosis patients for whom BP therapy is being contemplated should have their dental status assessed prior to initiation of the BP therapy. This current review discusses the effect of osteoporosis on oral health, oral implications of osteoporosis therapy as well as bisphosphonates related osteonecrosis of the jaw.