Bone Mineral Density, Smoking and Alveolar Bone Loss

There is evidence suggesting that alveolar bone loss is related to a variety of risk factors. Smoking is a recognized risk factor. Osteoporosis may have an adverse effect on alveolar bone height, but this has not been proven definitely. In addition, estrogen can have effects on the skeletal system.

To examine the effects of these factors on alveolar bone height, Hildebolt CF of Washington University,   St. Louis, studied the influence of smoking, osteoporosis and estrogen exposure on alveolar bone height in post-menopausal women.   

Researchers examined 134 women (mean age 59 years). None of the women demonstrated probing depth of 35 mm, so the influence of existing periodontitis was not a concern. Vertical bitewing radiographs were used to measure the distance from the cementoenamel junction to the alveolar crest for all teeth except third molars. Osteoporosis was assessed by absorptiometry, the standard diagnostic procedure.

Data were also collected about smoking history and factors related to estrogen exposure, including age at onset of menopause, the number of pregnancies, the number of births and oral contraceptive use. Calcium intake was also estimated.

Several variables correlated positively or negatively with alveolar bone height. Age, number of pregnancies, number of pregnancies to term and smoking (total pack-years) had a positive correlation with alveolar bone loss, while bone density had a negative correlation with alveolar bone loss. When these factors were considered together, the number of births, smoking and the interaction of bone density (a measure of osteoporosis) and smoking were in dependent risk factors for alveolar bone loss.

This study supports the conclusion that many factors can influence alveolar bone loss, and these factors can be related. Smoking is certainly important. Osteoporosis may be important to the development of bone loss when influenced by the effect of smoking.

Hildebolt CF, Pilgram TK, Yokoyama Crothers N, et al.

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