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Osteoporosis is defined as having an extremely low bone density mass index due to an imbalance of minerals, such as calcium and phosphate ions. These essential minerals are vitally important for proper bone structure and stability, and for maintaining normal healthy bone homeostasis.
Osteoporosis causes a mineral imbalance within the bone trabecula structures. This puts those suffering from this disease at an increased risk for bone fractures because the trabecula structures become weak, brittle and lose their stability. Severe osteoporosis may lead to decreased quality of life, disability, and morbidity if not properly maintained.
There are three major cells that are essential for proper bone remineralization and demineralization. These cells are also responsible for maintaining homeostasis of the bone trabecula structure and strength:
Osteoblasts: Specific for bone growth and repair for new bone-cell formation.
Osteoclasts: Specific for bone dissolving (demineralization) so that a fresh uptake of minerals, such as calcium and phosphoric ions, from the osteoblast cells can generate and metabolize healthy bone. Remineralization of the trabecular structure is important in maintaining healthy bone density levels and generating proper bone structural strength.
Osteocytes: These cells are actively involved in bone turnover from remineralization by way of the osteoblasts to demineralization by way of the osteoclasts. Osteocytes are the vital mechanosensory cell that keeps the ion channels (that provide calcium and phosphates) open and maintains communication between the two major cells that are responsible for bone density strength and stabilization.
Those suffering from Osteoporosis have a decreased production of calcium and phosphoric ions. Bone density levels will decrease and create fragility of the skeletal system. This can be extremely painful for those suffering from this debilitating disease and increases the risk for bone fractures and breaks.
Bone resorption is also prevalent in the jawbone of those suffering from Osteoporosis. The jawbone supports and nourishes the structures of the teeth. This is the correlation between good oral hygiene and Osteoporosis.
Those suffering from Osteoporosis are most commonly treated by a class of drugs called Bisphosphonates. Bisphosphonates aid in restoring normal bone homeostasis in those experiencing an imbalance of essential minerals, related to Osteoporosis. One major side effect of bisphosphonates is Osteonecrosis. Osteonecrosis results in the degradation of the jawbone due to a lack of blood and nutrient supply needed to maintain proper bone health in the oral cavity. Without adequate nutrient supply, the jawbone starts to necrose (die), and this can be extremely painful.
Eliminating predispositions for Osteoporosis will increase osteoblast activity to increase bone turnover, and increase osteoclast activity to demineralize bone to maintain normal bone density homeostasis.
Osteoporosis affects your systemic and oral health. It can be a debilitating and painfully progressive. We as health care professionals, need to ensure our patients are getting the best quality care that we can provide to them. Not only is it our job to educate our patients suffering with this disease on their oral and systemic health, but we also need to be an ear to listen and have great compassion and understanding for our patients suffering from all forms of diseases. Sometimes the best medicine for our patients is empathy with caring thoughtful words. It is our job as dental and medical professionals to make a difference in patients’ lives. We can do that one patient at a time.
CITED WORK:
1- Porter, J. L., & Varacallo, M. (2019, June 4). Osteoporosis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441901/
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