Assessment of Osteoporosis Risk Factors in the Female Dental Patient: A Demographic Study

Abstract

Osteoporosis has become a major public health problem as the size of the elderly population has continued to increase. While it is unclear as to the exact relationship between systemic bone disease and the craniofacial skeleton, the dental implications of osteoporosis could include dental implant failure, decreased residual ridge height, and unsuccessful orthodontics or oral surgery procedures. While these concerns remain speculative, it is important for dentists to recognize patients who exhibit high risk for osteoporosis. The purpose of this study was to evaluate risk factors for osteoporosis exhibited by female dental patients at Indiana University School of Dentistry and to assess this risk among the various dental specialty subpopulations. Based on general population averages, we hypothesized that approximately 20 percent of the female patients were at high risk for osteoporosis and that differences would be found among the various dental subpopulations. We also hypothesized that the number of teeth present would decrease as the risk for osteoporosis increased. A 12 question survey assessment tool was devised and administered to 220 female dental patients 18 years and older. This survey asked the patient to report selected vital statistics, menstrual status, and other aspects of lifestyle. The average overall age of the patients was 48.2±1.1 years. Of the 220 subjects, 34 percent exhibited serious risk factors for osteoporosis. The orthodontic subpopulation contained the fewest number of patients at high risk for osteoporosis (6 percent). However, they were also the youngest group (33.9±2.0). The complete denture subpopulation had the highest number of patients at high risk for osteoporosis (53 percent) and was the oldest (60.0±2.3). There was a trend for number of teeth to decrease as the risk for osteoporosis and age increased. We also found that in women who had taken hormone replacement therapy for at least five years, there was no association between number of teeth and years postmenopause. However, women who had very little or no hormone replacement therapy, there was a strong correlation for number of teeth retained to decrease as the number of years postmenopause increased (r=0.6). We concluded that there is a difference in dental subpopulations for osteoporosis risk. The clinical implications are that osteoporosis risk is much higher in specific classes of dental patients. Clinicians treating these patients must recognize the need to refer high risk patients for appropriate medical assessment.