Bone Loss Scores May Signal Gum Disease

February 22, 2015
Rachel Lutz

A postmenopausal woman's score on a fracture risk scale can tip off her clinicians to gum disease.

A postmenopausal woman’s score on a fracture risk scale can tip off her clinicians to gum disease, according to research published in Menopause.

Researchers from Case Western Reserve University School of Mental Medicine and Case/Cleveland Clinic Postmenopausal Health Collaboration examined periodontitis severity in postmenopausal women with World Health Organization Fracture Risk Assessment Tool (FRAX) scores that indicated a major risk for osteoporotic fracture (OPF) and in control subjects.

All participants were aged between 51 and 80 years, experienced menopause for a minimum of 1 year and maximum of 10 years, did not smoke, had hemoglobin A1C <7, and received no glucocorticoid, hormone, receptor activator of nuclear factor-kB ligand inhibitor, or bisphosphonate therapy within 5 years.

Nearly all of the 853 participants (90%) were categorized into the high OPF risk group, while 98 served as controls. Each patient underwent a periodontal check up that included probing depth for the gums, tooth loss, and attachment loss from ligaments holding teeth to bone.

“Our group’s overarching aim is to incorporate oral health into women’s health promotion. We believe that oral and systemic health are very much linked, so we explore those intersections,” corresponding study author Leena Palomo, DDS, MD explained to Pharmacy Times. “Many of the risks for osteoporotic fracture are also risks for gum disease. Osteoporosis and gum disease are said to share several mechanistic similarities, so we looked deeper.”

Because the high OPF risk group showed the strongest signs of gum disease, the researchers linked bone loss FRAX scores to gum disease prediction.

The fact that most health insurers do not cover dental procedures is a major drawback to those findings, the researchers noted. However, a change in health insurance policies to cover gum disease—given that is tied to patients’ overall health—would alleviate the issue.

In the meantime, patients at major risk for OPF might seek treatment from various clinicians, such as OB/GYNs, women’s health specialists, endocrinologists, and dentists—all of whom can recommend medication therapies. Because drugs can interact and cause adverse reactions, however, pharmacists are in an ideal spot to help manage patients’ concerns.

“The pharmacist may be the common denominator for a patient being managed by many clinicians for multiple conditions,” Dr. Palomo continued. “The trusted pharmacist may face a patient’s questions about the impact of medications to manage 1 condition may have on other conditions.”