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© 1998 Oxford University Press
research-article |
Tooth counts do not predict bone mineral density in early postmenopausal Caucasian women
aCity Hospital. Nottingham UK
bUniversity of Nottingham Medical School UK
cCenter for Clinical & Daslc Research Ballerup, Denmark
dOregon Osteoporosis Center Portland, OR, USA
eHawaii Osteoporosis Centre Honolulu, USA
Reprint requests: Mr SA Earnshaw, Department of Orthopaedic and Acddent Surgery. Queen's Medical Centre, Nottingham NG7 2UH. UK
BACKGROUND: It has been suggested that poor dental status may be a suitable criterion for bone densitometry referral in early postmenopausal women. We evaluated this hypothesis in a cohort of 1365 Caucasian women aged between 45 and 59 years, who were enrolled into an international multi-centre trial.
METHODS: Subjects were recruited at four study centres, using population-based techniques. Bone mineral density (BMD) at the lumbar spine and proximal femur was measured by dual energy x-ray absorptiometry (DXA) (Hologic QDR 2000). A full physical examination was performed including a tooth count.
RESULTS: Baseline tooth counts ranged from 0 to 32 (median 26): 84 (6%) subjects were edentulous. When classified according to the WHO criteria 445 (33%) of the subjects were osteoporotic at one or more of the skeletal sites analysed; 694 (5 1%) were osteopenic, and 226 (16%) were normal. Adjusting for confounding variables, there was no significant correlation between tooth count and BMD at any skeletal site. Subjects were divided into tertiles of tooth count, and x2 tests used to compare the two ‘extreme’ groups against the WHO criteria for BMD. At each of the six BMD regions the proportion of subjects with normal, osteopenic or osteoporotic BMD was similar for both tertiles.
CONCLUSIONS: We found no relationship between tooth count and BMD in early postmenopausal women. This may be because in younger women dental status is a reflection more of dietary habits and past dental surgery than of age-related bone loss. Tooth counts therefore cannot be used to identify individuals at risk of osteoporosis.
Keywords Osteoporosis, risk factors, tooth loss, bone mineral density, early postmenopause, screening
Accepted 17 October 1997
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