Monitoring bone mineral density (BMD) alongside proper oral healthcare may address the potential bidirectional link between BMD and caries, according to a study recently published in Scientific Reports.
Furthermore, BMD in the head may show a stronger impact on the decayed, missing, and filled permanent teeth or surfaces (DMFS) index for caries than other BMD sites, the author wrote.
"Monitoring BMD should be combined with appropriate oral healthcare and caries management strategies to effectively address these interconnected health issues, with particular attention to the monitoring of head BMD," wrote the authors, led by Haonan Zhang of Zhejiang Chinese Medical University (Sci Rep, November 25, 2024, Vol. 14, 29143).
To explore the link, data from the U.S. National Health and Nutrition Examination Survey 2011-2016 was used to analyze the relationship between BMD at various body sites and the DMFS index in 7,044 adults ages 20 to 59. Methods included multiple linear regression, restricted cubic splines (RCS), piecewise linear regression, logistic regression, weighted quantile sum regression (WQS), and mediation analysis.
BMD was measured across sites, including the head, limbs, ribs, spine, pelvis, trunk, and total body. The DMFS index, a detailed measure of dental caries severity, assessed untreated carious surfaces, missing teeth due to caries, and treated carious surfaces, offering greater sensitivity and insight into oral health, they wrote.
Linear analysis showed that all BMD sites, except the arm, were negatively correlated with the DMFS index for dental caries. RCS analysis revealed a significant U-shaped relationship between head BMD and the DMFS index (p for nonlinearity < 0.0001).
WQS analysis found a strong negative correlation between mixed BMD and the DMFS index (estimate: −0.023; 95% confidence interval [CI], -0.025 to -0.020), with head BMD having the greatest impact (weight: 91.4%). Mediation analysis indicated that inflammation does not mediate the effect of dental caries on BMD levels, they wrote.
However, the study had limitations. The cross-sectional design limits the ability to determine causality between BMD and the DMFS index, the authors added.
"There may be more complex nonlinear causal relationships between dental caries, inflammation levels, and BMD that are difficult to capture through simple mediation effect analysis, and further exploration using methods such as structural equation modeling may be needed in the future," they wrote.
