Is There a Correlation Between Oral Health and Risk of Fractures in Older Adults?

According to results from a multivariate linear regression analysis published in a recent issue of the journal Scientific Reports, there appears to be a noteworthy correlation between total tooth number and the likelihood of fractures in older adults (OA).

In this study, authors compiled and reviewed information from the Korean population by employing data from the Korea National Health and Nutritional Examination Survey (KNHANES) from 2008-2009, a nationwide population-based survey.  

The researchers sought to explore the relationships between the 10-year probabilities of fracture and factors related to oral health in the older patient population. Employing the Fracture Risk Assessment (FRAX) algorithm tool, the researchers computed the participants' 10-year probabilities of major and hip fractures.

A total of 2,322 Korean subjects over 65 years of age were included in this study, and the study population was comprised of 959 and 1,363 males and females, respectively. The participants were assigned to three groups based on the FRAX score for major osteoporotic fractures.  

The researchers performed a multivariate linear regression analysis to evaluate the correlations between oral health factors and FRAX scores. They corrected for confounding factors such as body mass index (BMI), number of teeth, Community Periodontal Index (CPI)score, history of metabolic syndrome, and dental patterns.

The authors wrote, “To the best of our knowledge, the present study is the first to reveal the relationships between the probabilities of fractures and oral health status after adjusting for factors related to osteoporosis and sarcopenia with sufficient sample size.”

Regarding results, the authors indicated that among the three groups of older males and females, they found no meaningful variations with respect to household income and education. No considerable variations were documented with regard to a history of smoking, alcohol use, level of physical activities, parental history of osteoporosis, personal account of recent falls, and lumbar spine, hip, or distal radius fractures.

The authors also noted that among both males and females, there were considerable variations in values of BMI, presence of metabolic syndrome, CPI scores, and quantity of present teeth and dental patterns.

Moreover, only among female participants in all groups were considerable variances in the  Decayed, Missing, and Filled permanent Teeth (DMFT) indexes recorded. The authors also indicated that among the males in all three groups, there were considerable variations in the areal bone mineral density [aBMD] of the femoral neck. In comparison, among the three groups in the female population, the aBMD of the lumbar spine and lean body mass revealed considerable variances.

Results revealed that the remaining number of teeth could have a robust correlation with regard to the probability of fractures among older patients.

Based on their findings, the authors wrote, “The novel finding of the present study was the strong link between the probabilities of fractures and the number of teeth present in the elderly. One interesting point was that significant associations between the individual history of falls and FRAX scores were detected in the female elderly only.”

The authors wrote, “Results from multivariate linear regression analysis demonstrated significant relationships between total tooth number and probabilities of fracture in male and female elderly. The interdisciplinary approach for handling osteoporosis and sarcopenia, including dentists, physicians is necessary to facilitate a better quality of life in the elderly.”

Reference

Hong, S.W., Lee, J. & Kang, JH. Associations between oral health status and risk of fractures in elder adults. Sci Rep 13, 1361 (2023). https://doi.org/10.1038/s41598-023-28650-9.