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Periodontitis and osteoporosis

There is an important correlation between osteoporosis and periodontitis, a multifactorial disease that leads to the destruction of the structures that support and stabilise the teeth (for example, the bone socket), which may cause loss of teeth in the more severe cases. The link joining these two diseases is Vitamin D, a hormone that plays a fundamental role in the development and maintaining of the bone tissue, as well as in the functioning of the immune and cardiovascular systems. A deficiency in Vitamin D represents a risk factor for the development of osteoporosis, and also has significant repercussions on the jawbones, which, if demineralised, give rise to the onset and progression of periodontitis.

Research assisting health

Thanks to our research on the variations in the gene that encodes the cellular receptor of Vitamin D (VDR), published in the scientific journal “Archives of Oral Biology”, we have been able to identify the genotype (in case of ‘TT’ homozygosity) associated with an increased risk of developing periodontitis. More specifically, the results of our study have highlighted a close correlation between alterations in this receptor – that manifests in homozygosity in approximately 20% of the population – associated with low serum levels of Vitamin D, and the development of periodontal disease.
An altered Vitamin D cellular receptor will be less efficient than normal, and this triggers a demineralisation trend in the bones, including the jaw.

The correlation between vitamin D, osteoporosis, and periodontitis

A systematic study by the dentist of Vitamin D metabolism often makes it possible to carry out a parallel diagnosis of increased risk for osteoporosis, even many years in advance. In fact, these patients come to have their teeth checked due to problems linked to periodontal disease (epidemiological studies show that more than 10 million Italians suffer from this disease) or for rehabilitation with osseointegrated bone implants, which often also requires intervention to increase the bone volume well before the time at which osteoporosis can normally be diagnosed.

This important discovery allows identification of the genetic variant long before the onset of osteoporosis and periodontitis. This encourages those who have this variant to take Vitamin D, eat healthily, and do some exercise in order to maintain healthy bones and teeth.

Prevention, before everything else

It is necessary to intervene with these subjects in a timely manner with adequate prevention by:

• administering active vitamin D and other dietary supplements,
• suggesting improvements to diet and lifestyle.

Prevention is a formidable tool for averting osteoporosis and its damage. The identification of this genetic susceptibility in young people may offer the chance for a mass screening with subsequent sending of these subjects to a specialist for an early bone mineral density test (‘BMD’) and appropriate follow-up.

This sort of large-scale prevention could have extremely important benefits in terms of cost savings for the national health system (just think of the 90,000 hip fractures a year), and also in terms of biological costs and improvement in the quality of life for patients.

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