Severe caries may be associated with an increased risk of osteoporosis (OP), supporting the potential connection between oral and systemic bone health. This study was recently published in BMC Oral Health.
Additionally, caries may increase the risk of postmenopausal osteoporosis with pathological fractures, the authors wrote.
"Proactive osteoporosis screening in patients with severe dental caries may be warranted for clinical consideration," wrote the authors, led by Gongzi Zhang of the Chinese PLA General Hospital (BMC Oral Health, March 5, 2025, Vol. 25, 340).
This study used Mendelian randomization (MR) analysis to assess the causal effect of oral diseases on OP, bone mineral density (BMD), and fracture risk. Additionally, summary-level meta-analysis data identified seven and 17 single-nucleotide polymorphisms as variables for periodontitis and decayed, missing, and filled tooth surfaces (DMFS), they wrote.
MR analyses were conducted on European individuals to examine associations with BMD while data from the FinnGen consortium were used to analyze OP, OP with pathological fracture, postmenopausal OP with pathological fracture, and site-specific fractures.
Single-variable Mendelian randomization (SVMR) and multivariable Mendelian randomization (MVMR) were applied to assess the independent causal effects of periodontitis and DMFS on various outcomes. The primary estimates were obtained using inverse variance weighted (IVW) methods, they wrote.
When periodontitis and the DMFS were analyzed together in MVMR, moderate evidence indicated that the DMFS was positively associated with osteoporosis risk (odds ratio [OR] = 1.165, 95% confidence interval [CI]: 1.020 to 1.331, p = 0.025).
In SVMR, IVW analysis provided moderate evidence that genetically predicted DMFS (β = 0.105, 95% CI: 0.006 to 0.205, p = 0.037) and periodontitis (β = 0.055, 95% CI: 0.008 to 0.102, p = 0.023) had causal effects on the lumbar spine BMD, they wrote.
After adjusting for periodontitis, the DMFS remained significantly associated with an increased risk of postmenopausal osteoporosis with pathological fracture (OR = 1.422, 95% CI: 1.027 to 1.969, p = 0.034, moderate evidence).
However, the study had limitations. The periodontitis data came from studies with varying diagnostic criteria, potentially leading to factors, including weak instrument bias, the authors added.
"Dental caries causally increases the risk of OP and postmenopausal OP with pathological fracture, suggesting the existence of teeth-bone axis," they concluded.
