By Kathi Valeii 

 Medically reviewed by Brian T. Luong, DMD

People with osteoporosis may be at greater risk of tooth loss due to low bone mineral density in the jaw and facial bones.1 This bone disease can cause bones to be fragile and increase the risk of fractures because the mineral content in your bones is low.

This article discusses how osteoporosis may impact teeth, how to prevent bone damage, and how to protect your teeth.

miodrag ignjatovic / Getty Images

Osteoporosis and Teeth

Research indicates osteoporosis may be associated with decreased oral health, including periodontal (gum) disease, jaw bone density, and tooth loss.2

Jawbone Density

Jawbone loss due to osteoporosis can result in dental health complications. You may be more prone to tooth loss without enough bone mineral density. And it can make replacements, like implants, dentures, and bridges, complicated because your bones may not be strong enough. Jawbone loss can result in facial collapse, leading to premature facial aging.34

Since jawbone thickness and porousness are visible in panoramic dental X-rays, some researchers have proposed using them as diagnostic tools for osteoporosis.4

Tooth Loss

Research found an association between tooth loss and osteoporosis. However, other factors, like age, smoking, race, menopause, oral hygiene, and hormones, play a role in tooth loss.5

One study evaluated the association between osteoporosis and dental health in postmenopausal South Indians.6 Researchers found that 39% of participants had osteoporosis. Among them, more than half had poor dental health, 43.5% had cavities, and 75% had tooth loss.

Gum Disease

Periodontitis (advanced gingivitis) and osteoporosis are characterized by bone resorption (bone shrinkage and loss). Many studies confirm a relationship between the two, and each disease may be a risk factor for the other.7

Risk Factors for Osteoporosis and Gum Disease

Osteoporosis and gum disease share some risk factors, including:7

• Older age

• Genetics

• Hormonal change

• Smoking

• Calcium and vitamin D deficiency

Osteoporosis Medication Side Effects and Teeth

In addition to the correlation between osteoporosis and oral health, some medications used to treat osteoporosis can impact your teeth. In particular, antiresorptive (bone strengthening) medications can cause a rare but serious condition called osteonecrosis, which can severely damage the jawbone.

Examples of antiresorptive medications include:8

• Fosamax (alendronate)

• Actonel (risedronate)

• Atelvia (risedronate sodium)

• Didronel (etidronate disodium)

• Boniva (Ibandronate Sodium)

• Boniva IV

• Reclast (zoledronic acid)

• Prolia (denosumab)

Osteonecrosis most often affects bone cancer patients receiving higher doses of these medications. While osteonecrosis can occur spontaneously, it more commonly occurs following traumatic dental procedures, like tooth extraction. It's important to tell your dentist if you take any of these medications because it may impact your treatment plan.

Preventing Bone Damage and Tooth Loss

While you don't have control over some factors, like genetics, your age, and hormones, there are some things you can actively do to prevent osteoporosis and tooth loss. They include:1

• Eating a nutritious diet

• Maintaining a weight that's healthy for you

• Getting enough calcium and vitamin D

• Being active

• Quitting smoking

• Limiting alcohol consumption

• Preventing falls

• Having good oral hygiene

• Getting regular dental care

• Telling your dentist about all medications you take

Treating Osteoporosis to Protect Your Oral Health

If you have osteoporosis, it's important to treat it to prevent its progression and protect your oral health. The following are common treatments for osteoporosis:9

• Medications

• Hormone therapy

• Calcium and vitamin D supplements

• Adequate exercise

• A nutritious diet

• Reducing risk factors like smoking, alcohol consumption, and falls

In addition, many people benefit from support through osteoporosis support groups, family, and friends.

Summary

Osteoporosis impacts oral health by increasing the likelihood of gum disease, jawbone density, and tooth loss. Further, while rare, the medications used to treat osteoporosis may cause severe bone loss in the jaw, so it's important to discuss your medications with your dentist, as it could impact your dental treatment plan. You can't always prevent osteoporosis and tooth loss, but a healthy lifestyle, adequate movement, and good oral hygiene are reasonable measures to limit your risk.

 Sources

New York State. Keeping your bones and teeth strong for life.

Anil S, Preethanath RS, AlMoharib HS, Kamath KP, Anand PS. Impact of osteoporosis and its treatment on oral health. Am J Med Sci. 2013;346(5):396-401. doi:10.1097/MAJ.0b013e31828983da

American Dental Association. Osteoporosis medications and medication-related osteonecrosis of the jaw.

Gulsahi A. Osteoporosis and jawbones in women. J Int Soc Prev Community Dent. 2015;5(4):263-267. doi:10.4103/2231-0762.161753

Darcey J, Horner K, Walsh T, Southern H, Marjanovic EJ, Devlin H. Tooth loss and osteoporosis: to assess the association between osteoporosis status and tooth number. Br Dent J. 2013;214(4):E10. doi:10.1038/sj.bdj.2013.165

Kapoor N, Cherian KE, Pramanik BK, et al. Association between dental health and osteoporosis: A study in South Indian postmenopausal women. J Midlife Health. 2017;8(4):159-162. doi:10.4103/jmh.JMH_21_17

Wang CJ, McCauley LK. Osteoporosis and periodontitis. Curr Osteoporos Rep. 2016;14(6):284-291. doi:10.1007/s11914-016-0330-3

American Dental Association. Osteoporosis and oral health.

International Osteoporosis Foundation. Treatment.

Giro G, Chambrone L, Goldstein A, et al. Impact of osteoporosis in dental implants: A systematic review. World J Orthop. 2015;6(2):311-315. Published 2015 Mar 18. doi:10.5312/wjo.v6.i2.311

By Kathi Valeii
Valeii is a Michigan-based freelance writer with a bachelor's degree in communication from Purdue Global.