Dental Caries increases risks of Osteoporosis with pathological fractures, BMC study

A recent study published in the journal of BMC Oral Health found dental caries to increase the risk of osteoporosis (OP) and postmenopausal OP with pathological fractures, indicating a possible teeth-bone axis connection. Patients with severe dental caries may benefit from proactive osteoporosis screening for early detection and management.

Dental caries (tooth decay) and periodontal (gum) disease are the 2 primary types of oral disorders, which are chronic and progressive in nature. The relationship between oral disease and osteoporosis has received constant interest due to a number of similar risk factors and biological processes. Chronic skeletal diseases, such as low bone mineral density (BMD), microarchitectural degradation, and an elevated risk of fracture, are characteristics of osteoporosis, much like dental disease.

According to recent research, there is growing evidence that osteoporosis, or a decline in bone mineral density, which may be a risk factor for less than ideal dental health. However, causal interpretation is limited by observational research's intrinsic confounding. Therefore, to quantify the causative effect of oral illnesses on osteoporosis, bone mineral density, and fracture risk, Gongzi Zhang and colleagues set out to do Mendelian randomization (MR) study.

This research identified 7 and 17 single-nucleotide polymorphisms (SNPs) for periodontitis and DMFS (the sum of Decayed, Missing, and Filled tooth Surfaces) as the instrumental factors for this study using summary-level GWAS meta-analysis data from the GLIDE collaboration. MR studies of these instruments were conducted on persons from the FinnGen consortium for OP, OP with pathological fracture, postmenopausal OP with pathological fracture, and site-specific fractures.

This was same for European adults for the relationship with BMD of the forearm, femoral neck, and lumbar spine. This study simultaneously evaluated the independent causative effects of PD and DMFS on various outcomes using single-variable Mendelian randomization (SVMR) and multivariable Mendelian randomization (MVMR). Inverse variance weighted (IVW) techniques were mostly used to produce the estimations. The weighted median, MR-egger, and leave-one-out test were among the sensitivity analyses.

The outcomes of this study found beneficial causative effect of DMFS on osteoporosis and postmenopausal OP with pathological fractures in MVMR after controlling for PD. Yet, the single-variable Mendelian randomization (SVMR) study did not reveal these causal linkages. Several sensitivity studies showed that the causal relationships were strong. Overall, dental caries suggests the presence of a teeth-bone axis by causally increasing the incidence of OP and postmenopausal OP with pathological fracture.

Source:

Zhang, G., Zheng, J., Zhou, Y., Zhou, M., Zhang, J., Liu, Y., Geng, Y., Wang, W., Xin, M., Yang, B., Zhang, L., & Huang, L. (2025). From teeth to bone: dental caries has causal effects on osteoporosis and osteoporotic fracture. BMC Oral Health, 25(1), 340. https://doi.org/10.1186/s12903-025-05735-7