Although many consider teeth to be bones, they aren’t the same as the bones in the rest of our body. That brings up the question: Does osteoporosis affect teeth? Osteoporosis doesn’t affect the teeth themselves but rather the supporting structures of the teeth. On the upper jaw, this includes the skull and the maxilla, a bony structure attached to the skull that supports the teeth. On the lower jaw, the mandible, the movable part of the jaw, and the joints comprise the bone structure.
The condylar joint is a ball-and-socket joint that links the bottom jaw to the top through ligaments and muscles. The most common place we see osteoporosis would be in this joint. Some people have joint destruction, where their joints begin to fail in their jaw, which might be marked by ear pain, inability to open the jaw, pain when opening, or clicking/popping. Although popping or clicking is not always indicative of osteoporosis and instead means there’s dysfunction in the jaw, they can be symptoms of the disease. So while osteoporosis hasn’t been shown to cause periodontal disease, it can worsen the condition.
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What Is Osteoporosis?
Osteoporosis is a condition in a patient’s health where their bones are weakened by both bony destruction and inhibited mineral uptake. In fact, the word “osteoporosis” itself means “porous bone.” So not only are their bones getting weaker, but they’re also not getting the minerals or nutrients they need to function best. Genetics and overall nutrition are two significant factors that impact whether or not a patient might develop osteoporosis. Although it can affect anybody, osteoporosis is typically most common in older female patients.
How We Identify Osteoporosis
We identify osteoporosis of the jaw by taking Panorex® x-rays, which are the full upper-and-lower dental x-rays that show us the jaw joint. We can see jaw destruction on this x-ray when the joint is flattened or when it looks like it is adapting to the surface it runs against, which would be the condylar fossa (the jaw joint that connects to the skull).
In some patients with osteoporosis, we may see an increase in periodontal disease, but that’s likely not the main cause. Osteoporosis would only increase the effects of periodontal disease. It’s unlikely that the dental office would be the first place that osteoporosis is identified, but we do ask about it when discussing health and family history. Knowing that a patient has osteoporosis gives us more insight into what might be causing joint pain or other issues for patients.
Treating Joint Dysfunction
Treating patients with joint dysfunction is the same regardless of whether the patient has osteoporosis. However, treatment for patients with osteoporosis sometimes includes bisphosphonates. Bisphosphonates help with slowing down the thinning or destruction of the bone. When patients on bisphosphonates have teeth removed or implants placed, they can experience MRONJ, or medication-related osteonecrosis of the jaw. This is where the exposed bone does not heal well, which can be detrimental to a patient’s dental care.
That’s why it’s essential for patients receiving treatment for osteoporosis to develop a good relationship with their dentist. A dentist can evaluate the patient to ensure they don’t need any teeth removed before they start bisphosphonate treatment. We would never suggest bisphosphonates for patients with osteoporosis in the jaw. That would be something a primary care physician would recommend upon identifying osteoporosis elsewhere in the body.
How We Help Osteoporosis Patients
Although osteoporosis does affect teeth, we typically refer patients with this disease to an oral surgeon for dental extractions and other invasive procedures. An oral surgeon can check certain blood levels for indicators that tell them it may not be safe to pull a tooth. They will also ensure to fully close the gums after extracting the teeth by using sutures to leave as little of a healing area as possible. Oral surgeons will also be more adept at medically treating that patient in the future if they do experience MRONJ.
At Cedarwood Dentistry, we cultivate dental health through personalized care. We offer a variety of dental services, including family dentistry, cosmetic dentistry, and emergency care in Midlothian, Virginia. Whether you last visited the dentist six months or six years ago, we can help bring your smile to life. Schedule your dentist appointment today by calling 804-379-9375.