Dental Problems

Osteoporosis

Osteoporosis is a crippling disease that affects at least one in four women over the age of 60. It is a condition in which bones become more porous and susceptible to fractures. Many bones of your body, including your jaw bone, are affected. This page explains what osteoporosis is, how it affects your dental health, and how it might be prevented.

Osteoporosis is a very common and poorly understood condition of middle and old age. Until recently many of the symptoms, such as shrinking in size or becoming stooped over, were considered a natural part of ageing. We now know that these are symptoms of a disease which literally means 'porous bones'. The bones become weaker and thinner and are more likely to fracture. As this happens, the bones of the spine are no longer able to support the weight of the body. They become compressed. This can lead to 'dowager's hump', back pain, or even collapse.

Osteoporosis is Booming
Osteoporosis is a serious, disabling condition. Its risk increases with age and is greater among women than men. Approximately one out of every four women over 60 years of age is afflicted. Even more alarming is that the number is growing at a rapid rate. The 'baby boom' generation is moving toward middle age. Many women of this generation drink less milk than earlier generations, are postponing childbearing, and are breast-feeding their children. All of these factors contribute to osteoporosis.

Jaw Bone Shrinkage
Not only does osteoporosis increase the likelihood of bone fractures (most commonly in the hip, wrist, and spine), but it also affects the jaw bone. It is an especially serious problem for those who have lost some or all of their teeth. Teeth help preserve bone, and bone slowly disappears (resorbs) in areas where teeth have been extracted. People who have osteoporosis experience accelerated bone loss. Recent research indicates that this can speed up periodontal disease. Periodontal disease attacks gums and bones supporting the teeth. In advanced stages, it can cause the teeth to become looser and ultimately fall out.

Poorly Fitting Dentures
Bone shrinkage which occurs from osteoporosis also means that fitting dental appliances, such as dentures, becomes a nightmare! Dentures must be constantly refitted or remade to lower and poorer levels. This situation can be terribly frustrating to both the dentist and the patient. It's like trying to keep your clothes fitting while you are rapidly losing weight.

Because it is so difficult for the dentist to fabricate well-fitting and functioning dentures, patients often suffer from many difficulties with speaking, eating, chewing, and swallowing. Eating becomes more difficult, so highly refined foods are frequently substituted for more nutritional foods. Poor nutrition can further damage the oral tissues and worsen the osteoporosis. Added to this are emotional consequences. When people can't eat, or have very poor nutrition, they often become depressed. It may even feel embarrassing to eat in public. The condition then becomes a downward cycle in which bone loss contributes to poor nutrition and self-esteem. The disease gets worse - along with the ability to deal with it.

The good news is that osteoporosis is a preventable condition. It is important to realise that the disease has a very slow onset. One does not come down with osteoporosis overnight.

Living Bone Tissue
The bone in our body is living tissue which is constantly remodelling throughout our life. Old bone is continually reabsorbed by the body and new bone is produced to replace it.

During the first half of life, up to the age of about 55, the rate of new bone formation exceeds the rate of resorption. After 35, the rate of resorption and new bone growth balances for a while. Then, after menopause, this balance shifts so that calcium is removed from the bones faster than it can be replaced. This is a natural part of the ageing process. However, with osteoporosis the bone loss occurs at a dangerous rate - it is an exaggeration of the normal process.

Prevention
Though osteoporosis is difficult to reverse once it is well-established, preventative measures can be taken to lower the risk. These include:

Diet
You should consume a reasonably high amount of calcium each day by eating foods high in calcium. Special care to increase calcium intake should be taken during pregnancy and lactation and during and after menopause.Your body also requires adequate amounts of vitamin D (400 IU daily) which you can get from two pints of milk, an average multivitamin pill, or 30-60 minutes of sunshine. Too much vitamin D can be harmful. Excesses of protein, alcohol, and caffeine will also contribute to bone loss.

Foods High in Calcium

  • Milk (skimmed milk is fine)
  • Yoghurt
  • Cheese and other daily products
  • Dark and green leafy vegetables
  • Almonds

Daily Calcium Needs

  • Before menopause 1000 mg
  • During menopause 1200 mg
  • After menopause 1500 mg

Exercise
Physical activity helps to stimulate the production of bone tissue. Walking, dancing, jogging, or bike riding are especially good because these activities put moderate stress on the spine and long bones of the body.

Hormones
After menopause, replacing the lost hormone oestrogen along with its companion progesterone can reduce bone loss. However, hormone replacement does have its risks and side effects, and is not necessarily desirable for all women. This must be moderated by your physician.

Seeking Help

If you think that you have osteoporosis, talk to your physician or dentist. All women should be on the alert to prevent this disabling and painful disease.

Where to find us
Based in Argyll, on the West Coast of Scotland, Stewart Wright currently practices two days per week in Oban.