Osteoporosis

      Basis of Current Understanding: Early Cross Sectional and Prospective Studies

      Strength of Statistical Evidence: Weak

      Studies Link Periodontal Treatment to Reduction of Disease:  No

      Reported Risk: Unknown

      The proposed link between gum disease and osteoporosis makes sense at first blush, because both diseases involve bone.  In gum disease, toxins from bacteria can destroy bone directly.  However, the most significant bone loss comes from the body’s reaction to the bacteria.  White blood cells fighting the Periodontal Disease infection release a number of chemicals that are know to destroy tissues and bone.  These include collagenase, hyaluronadase and fibrinogen.  Because gum disease is a systemic inflammatory disease, it results in increased levels of cytokines.  Cytokines are active protein molecules that effect changes on a vast array of bodily functions. One of these effects has been shown  in the laboratory to change the equilibrium between the cells that create and destroy bone.  Instead of favoring bone stability, the equilibrium between osteoblasts and osteoclasts shifts to favor osteoclasts and bone destruction.  Since this is more than a local effect, we might expect to see more bone loss in post-menopausal women with osteoporosis.

      A number of studies have examined this relationship.  A recent study has shown a significant correlation between periodontal bone loss and bone density in the jaw bone (Tizel, et al.).  A few studies have found non-significant correlations between bone mineral density (BMD) and gum disease while others have failed to find any correlation at all.  At this time, the relationship between periodontal Disease and Osteoporosis must be considered speculative.