Association between periodontal disease and bone mineral density in postmenopausal women: A cross sectional study

Objectives: Both periodontitis and osteoporosis represent major health problems especially in elderly women. The relationship between the two diseases and oral bone loss is important having significant public health impact in the prevention of morbidity and mortality related to these disorders. The present study was aimed to investigate the possible association between osteoporosis and periodontal disease among postmenopausal women residing in Goa, India. Study design: A complete periodontal examination (all teeth except third molar) including plaque index (PI), gingival index (GI), clinical attachment loss (CAL) measurement was performed on 80 dentate Goan postmenopausal women (age >= 50 yrs) with generalized chronic periodontitis. Mean alveolar bone loss (ABL) was measured from full mouth intraoral periapical radiographs, by recording the distance from cementoenamel junction (CEJ) and the most coronal portion of alveolar crest at mesial and distal aspect of all teeth except canines and third molars. Systemic bone loss was determined from hand-wrist radiograph of the patient through Digital X-Ray Radiogrammetry. Statistical analysis was done to assess the relationships between periodontal variables and bone mineral density (BMD) after adjusting for age, years since menopause, body mass index (BMI), smoking, number of remaining teeth, PI and GI. Results: Age of the patient, years since menopause and BMI showed significant correlation with BMD. CAL and ABL showed mildly negative and statistically nonsignificant correlation with the BMD. Of all the variables studied, only smoking and BMI were strong predictors of BMD. Conclusion: Skeletal BMD is related to interproximal ABL and CAL, though not to a statistically significant level; implicating postmenopausal osteopenia as a risk indicator for periodontal disease.