Angular Jawbone Loss and Osteoporosis

Here at OsteoporosisConnection we get inquiries about angular bone loss and osteoporosis, so we'd like to explain what angular bone loss is and its relationship to bone loss in other areas of the body; what causes it, how it's detected and jawbone loss treatment.   We'll also discuss whether jaw bone loss is a precursor to osteoporosis and the connections between jaw bone loss and periodontal disease.

Angular bone is located in the lower jawbone called the mandible.  The maxilla is the bone that makes up the upper jaw.   If you should have angular bone loss, you most likely have bone loss in the maxilla (upper jaw) as well.

What Causes Jaw Bone Loss?

  • Trauma - tooth may be broken off or knocked out.
  • Extractions - bone stimulation slows down as soon as a tooth is extracted.
  • Dentures - some ill-fitting dentures prevent normal bone stimulation necessary for the remodeling process.
  • Bridgework - unanchored teeth within the bridgework will cause deterioration of the gum and bone due to a lack of stimulation.
  • Malalignment-alignment issues from untreated extractions can cause bone deterioration.
  • Bite Abnormalities - abnormal bite surfaces also cause loss of bone structure.
  • Gum Disease - that's untreated (periodontitis) can cause destruction of all tissue, including the bone and all other tissues due to infections.

How is Jawbone Loss Detected?

Generally this problem is discovered during routine dental x-rays and other periodontal examinations that measure pockets that form around the gum and teeth due to bone loss.   Dentists have found that dental x-rays are very effective in determining those patients with osteoporosis and with those who have normal bone density measurements.

How do we Treat Jawbone Loss?

  • Immediate replacement of extracted teeth with implants
  • Bone graft surgery
  • Periodontal treatment including antibiotics

Is Periodontal Disease a Precursor to Osteoporosis?

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There is a strong and direct correlation between periodontal disease, jawbone loss and osteoporosis.   A number of studies were done on this issue, but the underlying reasoning to the connection between these three disorders are not well understood.   According to the National Institute of Arthritis and Musculoskeletal and Skin Disease "It is possible that the loss of alveolar bone mineral density leaves bone more susceptible to periodontal bacteria, increasing the risk for periodontitis and tooth loss."   "For example, older women with osteoporosis are three times more likely to experience tooth loss than those who do not have the disease."   Due to this tooth loss, some of us worry that we may have osteonecrosis of the jaw, even if we haven't taken a bisphosphonate, but we must understand that tooth loss with bone loss (osteoporosis) is quite common.   Tooth loss is not the main symptom of osteonecrosis, so I hope this eases some of your minds.   This does not mean that osteonecrosis isn't occurring in those who take a bisphosphonate medication, it is, but if you haven't taken these drugs or even if you have, you can lose some teeth due to your bone loss in the jaw since the tooth structure no longer has the strong bone to hold the tooth in place which can cause tooth shifting, movability and sometimes eventual loss of the tooth from it falling out.

I hope this helps to explain some of the intricacies of the connection between jawbone loss and osteoporosis, and how we go about detecting and treating it to save our teeth as we age.   Remember, keeping our bones healthy is important for dental health too.


Oral Health and Bone Disease:  National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2010

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