Osteoporosis is a disease that causes the loss of bone mass and density. It can lead to weak bones, which can lead to more serious injuries.

Like many people with osteoporosis, you may wonder if it will affect your teeth. The short answer is: not directly. Since your teeth aren’t actually bones, osteoporosis itself doesn’t change your teeth’s health or composition.

Osteoporosis can affect your teeth in other ways. It can cause changes to your jaw, which can affect how your teeth are held in place. Osteoporosis has been linked to an increased likelihood of tooth loss.

It is important to brush your teeth and learn about osteoporosis and how it may affect your oral health. We will review what we know about teeth and bones, how osteoporosis affects teeth, and how treatment works.

Although they have some similarities, your teeth and bones are not made of the same materials. The bones are mostly made of calcium and collagen. The teeth have the following main layers.

  • enamel is the hard calcified tissue on the top (crown) of teeth that isn’t made of living cells
  • cementum is another type of hard tissue that protects a tooth’s root
  • dentin is below enamel and cementum, making up most of our teeth’s interior and providing structure
  • pulp is the innermost layer of our teeth and contains nerves and blood vessels

Your bones are damaged by osteoporosis, which makes it hard for them to produce new tissue. The crown of your teeth has a grayish-white substance that looks like bone. Unlike our bones, enamel is not made of living tissue.

The link between osteoporosis and tooth loss is well-established and has been the subject of many scientific studies. These include:

  • The 2009 Osteodent study measured the bone density of 651 women. Researchers found that women with osteoporosis tended to have three fewer teeth on average than the women who didn’t have the health condition.
  • A 2013 study collected data from 333 people, 27% of whom were osteoporotic — that is, they showed signs that their bones had grown weaker and brittle. The study authors concluded that having osteoporosis was “significantly correlated with reduced tooth number,” specifically for molars.
  • A more recent study from 2017 also found that postmenopausal women in South India were more likely to experience tooth loss if they had developed osteoporosis.

Researchers are pretty sure that osteoporosis and tooth loss are related, but they are still trying to understand the connection.

The link is based on the idea that as osteoporosis progresses, your jawbone also weakens and loses some density. Some teeth lose their stability when the jawbone weakens. The alignment of teeth may be affected by these changes to the jawbone.

If you take medication for osteoporosis, you should talk to your doctor about the effects on your teeth. It is possible that medications that strengthen bones can cause damage to your jawbone.

The most common treatment for osteoporosis is the drug, bisphosphonate therapy.

Bisphosphonates, which can be administered orally (by mouth) or intravenously (through a vein), can help strengthen your bones and ward off future fractures. Many people also take calcium or vitamin D with bisphosphonates, according to the American College of Rheumatology.

But there’s a risk to your jaw and teeth when you take bisphosphonates. This type of treatment has been linked to the development of a rare degenerative complication called osteonecrosis of the jaw (ONJ).

According to the Endocrine Society, the risk of developing ONJ is highest after dental surgery. It tends to occur more frequently in people who have undergone “high-dose, long-term therapy, as might be given during cancer treatment.”

One of the most important things you can do is to maintain good dental habits that will help you with your overall well-being.

Key factors include:

If you are having trouble getting enough calcium or vitamins D and E from your diet, you should talk to your doctor or a nutrition expert. Make sure you always take your supplements.

Proper dental hygiene is essential for the long-term health of your teeth. The American Dental Association (ADA) recommends the following:

  • Twice a day, brush your teeth.
  • Use toothpaste that contains fluoride.
  • Flossing, interdental brushes, and others are included in the daily cleaning of your teeth.
  • Limit your intake of sugary beverages and snacks.
  • You should visit your dentist for regular checks.

Let your dentist know if you’re taking an antiresorptive agent, like a bisphosphonate, so they can accommodate it in your treatment plan — especially if you’ll be undergoing any procedures like a tooth extraction. You likely won’t need to stop taking your osteoporosis treatment or skip the procedure, according to the ADA, but your dentist may need to make some accommodations.

Know your risk

“If you have any dental health concerns or have certain risk factors for osteoporosis, it’s important to keep an eye on your oral health.”

Your chances of developing osteoporosis increase as you get older. Women tend to be at elevated risk, and the loss of estrogen that occurs with menopause can also contribute.

Learn more about osteoporosis risk factors and who should get screened.

Currently, there’s no cure for osteoporosis, so prevention remains the best strategy. However, there are several osteoporosis management and treatment options, according to 2018 research.

Certain drugs for osteoporosis aim to prevent bone loss (antiresorptive medications) while others seek to regrow bone (anabolic medications). Both classes of drugs aim to increase bone density and lower your chance of fractures.

Your doctor might tell you what to take depending on your health and needs.

  • Bisphosphonate medications. These are usually the first medication prescribed for postmenopausal women, and they work by slowing the breakdown of bone.
  • Selective estrogen receptor modulators (SERMs). This class of medications is also known as estrogen agonists. SERMS, most commonly raloxifene, are also used to treat osteoporosis in women, as well as other conditions like breast cancer.
  • Hormone replacement therapy. These drugs are synthetic versions of our naturally occurring hormones. Since loss of estrogen due to menopause can contribute to osteoporosis, estrogen therapy can help, although it’s often not the first-line treatment for osteoporosis. Testosterone therapy is sometimes used similarly for osteoporosis in men.
  • Calcitonin. This is a synthetic version of a hormone produced by your thyroid gland that regulates calcium. It comes in a nasal spray and is approved by the Food and Drug Administration (FDA) for treating osteoporosis in certain postmenopausal women.
  • Antibody medications. Also called biologics, these can slow the breakdown of bone and encourage new bone formation. The two available drugs are denosumab and romosozumab, both administered through injections.
  • Parathyroid hormone therapies. Parathyroid hormones (PTHs) increase bone density and strength, helping prevent fractures. The PTH injectable medications teriparatide and abaloparatide are both FDA-approved to treat osteoporosis.
  • Calcium and vitamin D supplements. These are essential for building and maintaining strong bones (and teeth).

Physical therapy (PT) is also often used to treat osteoporosis and aims to strengthen muscle and bone to prevent future fractures (or recover from fractures). A PT exercise regimen will be tailored specifically to your health needs. It can be done in a few minutes per day at home or at regular sessions with your physical therapist.

“Osteoporosis doesn’t affect teeth because they are not bones. Osteoporosis can cause changes to your teeth.”

Maintaining healthy habits will help with bone and oral health. This includes not smoking, eating a balanced diet, exercising regularly, and practicing proper dental hygiene.

Treatments for osteoporosis can help slow down the disease and promote bone growth. Your dentist can help you with any oral problems that may occur due to osteoporosis or its treatment.