Longitudinal Study of Periodontal Disease and Edentulism With Rates of Bone Loss in Older Women

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Abstract
Previous cross-sectional studies have suggested a link between periodontal disease and osteoporosis. The purpose of the present study is to evaluate the association between changes in bone mineral density (BMD) and clinical signs of periodontal tissue destruction and tooth loss over a 2-year period. A total of 398 women (mean age 75.5 years) were randomly selected for an ancillary study of periodontal disease; osteoporosis in association with the presence or absence of teeth was evaluated. Osteoporosis in association with periodontal disease was also evaluated. All subjects were participants at the Pittsburgh Clinical Center for the Study of Osteoporotic Fractures (SOF), a prospective cohort study of women 65 years of age or older designed to determine risk factors for fractures. Oral health examinations, including periodontal probing and attachment loss, were performed at the fourth clinical visit, an average of 6 years after baseline. BMD of the total hip and its subregions was measured using dual energy x-ray absorptiometry at the time of dental examination and 2 years later. Results are expressed as annual percentage change. A total of 145 (36.4%) women were edentulous and 163 (80.7%) of the dentate women (N = 253) had periodontal disease. Dentate women reported higher education (P <0.001) and a higher calcium intake (P= 0.002). Absolute BMD and percentage change in BMD were similar in dentate and edentulous women. We found no difference in BMD or in absolute or percentage change in BMD between women with or without periodontal disease. Little evidence exists for an association between edentulousness, periodontal disease, and longitudinal changes in BMD.