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I've heard that x-rays of my teeth can be an indicator for osteoporosis. Is that true?

It is important to keep up with your oral health checkups throughout your entire life. When you go to the dentist, you may find out more than the condition of your teeth and gums—you may find out that you should be tested for osteoporosis. Although osteoporosis cannot be diagnosed from conventional bite-wing dental x-rays, periodontal (gum, tissues, and bone supporting teeth) disease can suggest that you have osteoporosis. Loss of teeth and bone loss in your jawbone can also indicate that you may have osteoporosis. Bone loss, depending on its extent, is sometimes visible on oral panoramic x-rays[1].

If you already have osteoporosis, your gum disease may become more severe. It is not clear yet whether low bone mass causes more rapid gum loss or if the inflammation of the gum tissue leads to more loss of bone density. Either way, if you have periodontal disease[2], you should discuss BMD testing with your clinician.

As your gums become inflamed and recede, you may lose teeth. Tooth loss is definitely a predictor of osteoporosis. If an x-ray (usually a panoramic x-ray) of your jawbone shows bone loss, you are likely to have loss of bone mass in other bones as well.

Calcium and vitamin D intake is important not just for your bones but also for your teeth. So if you are not getting enough of either one, you are not only at risk for osteoporosis but also for tooth loss. If you have poor oral health, this does not mean that you definitely have weak bones. And on the other hand, if you have osteoporosis or osteopenia, it does not mean that you have bad teeth and gums.

Your oral health can offer clues that might prompt a discussion with your primary care clinician about osteoporosis.

Because osteoporosis is such a silent disease initially, it is important to consider every clue that you might have it. So, go to your dental professional twice a year for a cleaning and evaluation—your oral health can offer clues that might prompt a discussion with your primary care clinician about osteoporosis. And if you are contemplating tooth implants, it is critical to inform your dental professional if you have osteoporosis because tooth implants must be rooted in strong bone.

What should I do to prepare for the BMD tests? When my clinician orders the tests, how soon should they be done? If my provider can't schedule my tests for 6 weeks after they're ordered, is that OK?

Although many tables have a pad, some women are uncomfortable lying down on hard x-ray-type tables for BMD tests that measure the bone density of their

hips or spine. You can ask for a pad or a wedge for under your knees if you are uncomfortable lying on the table. All BMD tests are essentially painless and noninvasive. There are no dyes to drink, no intravenous lines to be inserted. You don't need to fast for 2 days or go without eating and drinking after midnight. You should not, however, have BMD tests done if you have had studies with contrast dye[3] within the past 2 weeks. You also should not have BMD testing while you are pregnant. You won't be able to undergo some of the BMD tests if you weigh over 250 pounds.

Do not take your calcium supplements for 24 hours before your test. Although the tests don't take long, wear comfortable clothing like sweatpants and a t-shirt. You should not wear clothes with metal clasps or metal zippers. Leave your underwire bra and bellybutton ring at home as well.

BMD testing is rarely ordered on an emergency basis. So, waiting a month or 6 weeks to get an appointment is okay. Naturally, when the tests are ordered, it's best to get them done as soon as you reasonably can.

  • [1] A type of radiography, usually of teeth and surrounding bones, such as the jawbone.
  • [2] Disease of the gums, tissues, and bone supporting teeth.
  • [3] A dye that is given orally or intravenously for the purposes of focusing certain types of imaging tests; should not be taken within 2 weeks before having a bone mineral density test.
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