Osteoporosis is a mammoth problem in our country.

The word osteoporosis literally means “porous bones”. The condition occurs when our bones lose calcium and minerals, causing them to become weak and brittle. Bone is a living tissue that is constantly changing, yet when the creation of the new bone doesn’t keep pace with the removal of old bone, osteoporosis occurs. As a result of this, people are more pruned to experience fractures, even while doing everyday simple tasks.

In this column, we will discuss the frustrating challenges with osteoporosis, associated dental side effects and options for treatment.

The quality of our bone affects all parts of our bodies, not just our spines and hips. In this way, osteoporosis; or the weakening of bones, has an immediate connection to early tooth loss.

According to the National Institute of Health, women with osteoporosis are three times more likely to experience tooth loss than those without the bone disease.

How common is osteoporosis? Osteoporosis is a major public health threat for about 44 million Americans, or for more than half of those 50 years and older. In The Bahamas, it is believed that more than 60 thousand people have osteoporosis or are at risk.

In 2009, a study conducted at University of Athens Dental School evaluated 665 females ages 45 to 70. The number of teeth and density of the bones in the hips, neck and lumbar spine were measured. The results demonstrated that participants with osteoporosis had an average of three fewer teeth than subjects without the bone disease. This study further corroborated other studies showing that osteoporosis is associated with early tooth loss in adults.

Management of osteoporosis with medications like bisphosphonates certainly added to the bone challenge. Here is why: The most common treatment for osteoporosis are the class of medications referred to as bisphosphonates. These meds can have serious side effects and severe dental implications. The most serious of the side effect is a condition called Osteonecrosis of the jaws (ONJ). Osteonecrosis can occur spontaneously or can be associated with tooth extractions and/or a local infection. Because of these medications; like Fosamax, Actonel and Boniva, the unfortunate effect is delayed bone healing. This delayed healing causes jaw infection, pain and suffering. The bone just doesn’t heal well. Areas of the jaw bone becomes necrotic or rotten and can literally flake off. This is because, the decaying bone cannot receive adequate blood supply to remain nourished and replenished.

These medications work by blocking the mechanism to remodel bone. You see, bone is a living structure and the old bone must be removed by cells called osteoclasts. If osteoclasts stop working, then the old bone remains and new bone keeps forming. Since this mechanism affects the blood supply to the old bone, major infections could be the result. 

That said, then what is the best treatment for Osteoporosis?

If you have osteoporosis, there is even more reason for you to stay diligent on good oral hygiene habits. Dentists recommend that you floss once a day and brush twice a day, for two minutes each time. Undoubtedly, keeping a clean mouth greatly diminishes the chance for dental problems; including the loss of teeth. Many people think bone weakness should be accepted as a natural part of growing older. One of the best ways to reduce the risk for osteoporosis is by maintaining a well-balanced diet rich in calcium and vitamin D; which helps the body absorb calcium. As we age, we need more of these important vitamins. We should minimize acidic levels in the body by lowering the consumption of red meats because meats are acid forming. Eating fresh vegetables, as well as eggs, plain yogurt and beans are alkalizing. Also, exercise plays a pivotal role in preventing and treating osteoporosis. If you’ve been diagnosed, start a regular workout routine with resistance training to reduce the risk of bone loss. To ensure the benefits of your workout, talk to your doctor.

Osteoporosis may be a challenge as well as its prescribed treatment.

My best advice is to do as much as we can without medication. Sometimes, if you change your bad habits, the problem may resolve itself. Eat well, exercise, seek wise counsel and practice good dental hygiene. You just need to start now.


Dr. Kendal V. O. Major is Founder and CEO of Center for Specialized Dentistry which is a comprehensive family dental practice operating in Nassau and Freeport. He is the first Bahamian Specialist in gum diseases and dental implants since 1989. He also is a certified Fastbraces provider. His practice is located at 89 Collins Avenue, Nassau at (242)325-5165 or [email protected].


Osteoporosis of the Lower Right jaw. Bone has become brittle and subject to fracture and early tooth loss.

Biphosphonate related Osteonecrosis. Jaw is literally rotting away.

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