I have many postmenopausal women as patients.  I usually see them when they’ve broken a bone or have been referred to me for bone density studies.  Bone density studies show how bones are doing particularly after menopause when hormone changes can weaken bones.  Recent research, though, has shown that a bone density study may also be predictive of another health problem for older women.  Here’s what you should know…

Your Bone Scan Also Reveals Your Dental Risk

Like other orthopedic doctors, I make use of a fracture risk assessment tool, or FRAX, for short.  It tells me how likely a woman is to suffer a significant fracture, like her hip that immobilizes her; or her wrist/forearm that threatens her independence.  It’s been a reliable tool and has allowed me to identify certain patients who may need extra help in building their bone strength.

New research out of Case Western Reserve University has shown that FRAX can be invaluable in preventing another prominent condition of older women – periodontal disease.  Researchers found that women who had high risk scores on FRAX also had symptoms of periodontal disease, also known as gingivitis, or gum disease.  Why?

After menopause, women can suffer a dramatic decrease in bone loss due to decreasing estrogen scores.  Bone loss can affect the bones of the jaw as well. Shrinking bone density can mean recession of the tissues that hold teeth in the gums.  In addition, lower estrogen levels may mean increased inflammation throughout the entire body – including the mouth and gums.

An earlier study out of Case Western showed that women who took bisphosphonates (bone building drugs) had greater bone density in their jawbones than women who didn’t take them.  Yet, all the studies showed that the women in these age groups had abnormal levels of plaque buildup on their teeth.  Plaque is a sticky biofilm that increases bacterial growth around gum lines which can lead to inflammation of the gums (gingivitis) and even tooth loss.

But that’s just part of the problem. It’s now believed that gingivitis may even contribute to the development of heart disease from the inflammation it creates.  Infections in the gums can travel through the blood stream and affect the heart vessels.

Traditionally, dentists ask their patients to have twice yearly visits for check-ups.  These visits include gum probing to measure recession, as well as inspection/deep cleaning of plaque buildup.   Now, that the FRAX link to periodontal disease has been identified, orthopedists are looking closely at women with high FRAX scores and referring them for dental checkups.

Dentists, too, are now recommending that older women brush their teeth more than twice a day.  And, that they have office visits more than twice a year, perhaps even quarterly, to better remove plaque buildup and watch for developing periodontal disease and bone loss.  They too may start using the FRAX tool to better identify older women at risk. It may even turn out that their risk for bone loss may also be identified first by their abnormal plaque buildup.

Bone Scans and Your Health

Even though teeth should be checked a minimum of twice a year, bone scans should be done at least once after the onset of menopause.  According to a new study out of the Women’s Health Initiative, if a woman’s bone density is normal at that time, and she hasn’t had a fracture in the interim, another bone scan would not be needed until the age of 65.

Your Bones and Your Teeth

Your bones and teeth are a reflection of each other.  They’re made from the same basic materials.  If these bone/teeth building materials are lacking in your body, the strength of both bones and teeth will decrease. 

Be sure to get enough calcium and Vitamin D3 to keep both your bones and your teeth strong.  Aim for 1,200 mg of calcium in divided doses of 400 mg three times a day; and at least 1,000 IU of Vitamin D3. Vitamin C both helps to fight inflammation throughout your body but it also stimulates the production of bone, aim for 1,000 mg a day.  Also make sure you get enough bone stimulating exercise at least 3 times a week.  This is exercise where your feet are impacting the ground or floor as in running, dancing, or floor sports (basketball, soccer).  Weight resistance also helps stimulate bone growth by muscles rubbing against them during exercise.

Stay away from soft drinks that contain sodium bicarbonate and phosphorus which leech calcium out of both your bones and your teeth.  The acids in them also erode the enamel on your teeth which shields your teeth against plaque buildup and cavities.  If you drink fruit juice, rinse your mouth out afterwards as the acids in them do the same.

Certain foods like protein drinks can contribute to plaque buildup, so rinse your mouth or brush your teeth after consuming them.  Drink enough water every day as well.  A dry mouth can lead to plaque and bacterial buildup.  Drink half your weight in water ounces every day whether you feel thirsty or not.

Keeping your bones and teeth strong is important at any age but even more so as you get older.   Exercise, good dental hygiene, nutrition and water can help you stay disease free, independent and healthy.

Stay Well,
Mark Bromson, M.D.

Bone Loss Score Tips Doctors off to Periodontal Disease, http://www.sciencedaily.com/releases/2015/02/150217131302.htm

Postmenopausal women: More Than Twice A Year Dental Check-Ups http://www.sciencedaily.com/releases/2011/03/110310173210.htm

Bone Density Repeat Not Needed So Soon, http://www.sciencedaily.com/releases/2014/11/141111111705.htm

Keeping Bones and Teeth Healthy for Life, https://www.health.ny.gov/diseases/conditions/osteoporosis/bones_and_teeth_strong_for_life.htm