NIDCR/CDC
Dental, Oral and Craniofacial
Data Resource Center

Oral Health, U.S. 2002 Annual Report

Section 15: LINKS TO SYSTEMIC HEALTH/ MANIFESTATIONS OF SYSTEMIC DISEASE

Osteoporosis poses a major public health problem for the United States. Results from the NHANES III indicate that 13% to 18% (4–6 million) of American women over 50 have osteoporosis and 37% to 50% (13–17 million) have osteopenia (low bone mass, a major risk factor for osteoporosis) (Looker et al., 1997). Osteoporosis is more prevalent among white and Asian American women than among black women (US DHHS, 2000).

Osteoporosis is suspected of being a risk factor for oral bone loss (Wactawski-Wende et al., 1996). The alveolar processes of the maxilla and mandible provide the bony framework for tooth support and osteoporotic changes to these bones may directly affect tooth stability and retention (Birkenfeld et al., 1999). Kribbs et al. (1989) showed that the height of the edentulous ridge is correlated with body calcium and the mandibular bone mineral density. Greater periodontal loss of attachment was found in women with osteoporosis than in women without it (von Wowern et al., 1994). Estrogen replacement therapy affects oral bone in a manner similar to the way it affects other sites. Better tooth retention is a potential additional benefit for those using hormone replacement therapy after menopause (Grodstein et al., 1997; Krall et al., 1997; Birkenfeld et al., 1999).

SOURCE OF DATA
The analyses reported here are from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, National Center for Health Statistics, Centers for Disease Control and Prevention.

• Differences in osteoporosis prevalence
• A higher percentage of persons with osteoporosis were observed in older age groups between ages 45 and 84.
• A greater percentage of non-Hispanic whites had osteoporosis compared to non-Hispanic blacks or Mexican Americans (Figure 15.4.1).
• Women were about 10 times more likely than men to have osteoporosis.

Bullets reference data that can be found in Table 15.4.1.

REFERENCES
Birkenfeld L, Yemini M, Kase NG, Birkenfeld A. Menopause-related oral alveolar bone resorption: a review of relatively unexplored consequences of estrogen deficiency. Menopause: The Journal of the American Menopause Society 1999;6:129–133.

Grodstein F, Colditz GA, Stampfer MJ. Postmenopausal hormone use and tooth loss: a prospective study. J Am Dent Assoc 1996;127:370–377.

Krall EA, Dawson-Hughes B, Hannan MT, et al. Postmenopausal estrogen replacement therapy and tooth retention. Am J Med 1997;102:536–542.

Kribbs PJ, Chesnut CH 3rd, Ott SM, Kilcoyne RF. Relationships between mandibular and skeletal bone in an osteoporotic population. J Prosthet Dent 1989;62(6):703–707.

Looker AC, Orwoll ES, Johnston CC Jr, et al. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone and Miner Res 1997;12:1761–1768.

U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.

von Wowern N, Klausen B, Kollerup G. Osteoporosis: a risk factor in periodontal disease. J Periodontol 1994;65:1134–118.

Wactawski-Wende J, Grossi SG, Trevisan M, et al. The role of osteopenia in oral bone loss and periodontal disease. J Periodontol 1996;67(10 Suppl):1076–1084.

Figure 15.4.1. Prevalence of osteoporosis per 100 persons aged 45 and older by race/ethnicity and education

[D]

Note: Age standardized to the year 2000 U.S. population.

Data source: The Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994, National Center for Health Statistics, Centers for Disease Control and Prevention.

Department of Health and Human Services
National Institute of Dental And Craniofacial Research (NIDCR)	CDC Division of Oral Health
National Institutes of Health

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