Osteoporosis: A Common Metabolic Bone Disease with Special Interest to Dentists
You will receive 1 credit(s) of continuing education credit upon successful completion of this course. The purchase price of this course is $49.00


The title calls attention to a current subject of increasing interest in the dental profession.

Learning Objectives:

Upon completion of this course, participants should be able to do the following:

  1. be aware of how many people (including those in the participants practice) are affected by osteoporosis.
  2. be aware of oral and non-oral signs and symptoms of osteoporosis. 
  3. be able to discuss the disease with patients.
  4. be knowledgeable about the various treatments patients may be receiving.
  5. be aware of the risks of dental treatment for patients taking certain osteoporosis medications. 
  6. be aware of the morbidity and mortality of the disease and the common fractures involved. 
  7. know the various risk factors for osteoporosis that can be identified and be able to discuss how to avoid these risks with patients.


The course discusses how osteoporosis involves the skeletal bones, including the maxilla and mandible.  The causes of the disease are presented.  The treatment, both pharmacological and non-phamracological are presented.  Various related medications are discussed, including the risks related to dental treatment.  Adequate information is presented so the participant can discuss the disease and its treatments with dental patients, especially patients at risk for the disease.


Course Outline

  1. Introduction
  2. Etiology 
  3. Physiology
  4. Epidemiology
  5. Risk factors for Osteoporosis
  6. Signs and Symptoms of Osteoporosis
  7. Mortality and Morbidity
  8. Diagnosis of Osteoporosis
  9. Treatment of Osteoporosis
  10. Prevention of Osteoporosis
  11. Web Sites of Interest

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    2000; 48:218-25.
  2. Daniell HW.  Postmenopausal tooth loss.  Contributions to edentulism by osteoporosis and cigarette smoking.  Arch Intern Med 1983; 143:1678-82.
  3. Kribbs PJ.  Comparison of mandibular bone in normal and osteoporotic women.  J Prosthet Dent 1990: 63:218-22.
  4. Kribbs PJ, Chesnut CH, Ott SM, Kilcoyne RF.  Relationships between mandibular and skeletal bone in an osteoporotic population.  J Prosthet Dent 1989; 62:703-7
  5. Jeffcoat MK, Chesnut CH.  Systemic osteoporosis and oral bone loss: Evidence shows increased risk factors.  JDA 1993; 124:49-55. 
  6. Hildebold CF.  Osteoporosis and alsveolar bone loss.  Dentomaxillofac Radiol 1997; 26:3-15.
  7. Edwards DF, Magliorati CA.  Osteoporosis and its implications for dental patients.  JADA 2008; 139:545-52.
  8. Deal CL.  Osteoporosis: prevention, diagnosis, and management.  Am J Med 1997; 102 (suppl 1A):35S-36S.
  9. Kanis JA, Melton LJ, Christiansen C, Johnston CC, Khaltaev N.  The diagnosis of
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  10. Teegarden D, et al.  Peak bone mass in young women.  J Bone Miner Res 1995; 10:711-15.
  11. Slavkin HC.  Building a better mousetrap: toward an understanding of osteoporosis.  JADA 1999; 130:1632-36.
  12. Foundation for Osteoporosis Research and Education. www.fore.org
  13. Dequeker J, Westhovens R.  Low dose corticosteroid associated osteoporosis in rheumatoid arthritis and its prophylaxis and treatment: bones of contention.  J Rheumatol  1995; 22:1013-19.
  14. Saag KG et al.  Alendronate for the prevention and treatment of glucocorticoid-induced
    osteoporosis. N Engl J Med 1998; 339:292-99.
  15. Michel BA, Bloch DA, Fries JF.  Predictors of fractures in early rheumatoid arthritis.  J
    Rheumatol 1991; 18:804-08.
  16. Roberts WE, Simmons KE, Garetto LP, DeCastro RA.  Bone physiology and metabolism     in dental implantology: risk factors for osteoporosis and other metabolic bone diseases.  Implant Dent 1992; 1:11-21. 
  17. Roberts WE Garetto LP, Arbuckle GR, Simmons KE, DeCastro RA.  What are the risk factors for osteoporosis? Assessing bone health.  JADA 1991; 122:59-61.
  18. Groen J.  Chronic destructive periodontal disease in patients with presenile osteoporosis. J Periodontal 1978; 39:19-25
  19. Loze JC.  Osteoporosis and its relationship to oral bone loss.  Curr Opinion Periodontal 1996; 3:27-33.
  20. Jeffcoat M, Chesnut CH.  Systemic osteoporosis and oral bone loss: evidence shows
    increased risk factors.  JADA 1993; 124;49-56.
  21. Ferrari S, Rizzoli R, Bonjour JP.  Genetic aspects of osteoporosis.  Curr Opin Rheumatol
    1999; 11:294-300.
  22. Mayo Staff Dec. 2007.  www.mayoclinic.com/health/osteoporosis
  23. Slemenda CO.  Predictors of bone mass in perimenopausal women.  A prospective study of clinical date using photon-absorptiometry.  Ann Intern Med 1990; 112:96-101.
  24. Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ.  Effects of
    high-intensity strength training on multiple risk factors for osteoporotic fractures: a randomized controlled trial.  J Am Med Assoc 1994; 272:1909-1014. 
  25. Becker AR.Osteoporosis risk factors in female dental patients. A preliminary report. 
    Indiana Dental Association Journal, Summer 1997; 15-19.
  26. Tosteson AN, Rosenthal DI, Melton LJ, Weinstein MC.  Cost effectiveness of screening
    perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy.  Ann Intern Med 1990; 113:593-603.
  27. Tezal M, Wactawski-Wende J, Grossi SG, Ho AW, Dunford R, Genco RJ.  The
    relationship between bone mineral density and periodontitis in postmenopausal women.  J Periodontol 2000; 71:1492-8.
  28. Karayianni K et al.  Accuracy in osteoporosis diagnosis of a combination of mandibular
    cortical  width measurement on dental panoramic radiographs and a clinical risk index
     (OSIRIS): the OSTEODENT project.  Bone 2007; 40:223-9.
  29. Lloyd R.  Summary of the role of the dental surgeon in detecting osteoporosis:
    OSTEODENT study.  Br Dent J 2008, 204:560-61.
  30. Taguchi A et al. & OSPD International Collaborative Group.  Observer performance in diagnosing osteoporosis by dental panoramic radiographs: results from the osteoporosis screening project in dentistry (OSPD). 
  31. Ruggiero SL, Mehrota B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws
    Associated with the use of bisphosphonates: a review of 63 cases.  J Oral Maxillofac Surg 2004; 62:527-34. 
  32. Black DM et al.  Randomized trial of effect of alendronate on risk of fracture in women
    with existing vertebral fractures.  Lancet 1996; 348:1535-41. 
  33. Liberman UA et al.  Effects of oral alendronate on bone mineral density and the incidence
    of fractures in postmenopausal osteoporosis.  N Engl J Med 1995; 333:1437-43. 
  34. Schmidt LJ Rowe DJ.  The effects of bisphosphonates on alveolar bone loss.  Quintessence Int. 1987; 18:497-501. 
  35. Reddy MS, Weatherford TW, Smith CW, West BD, Jeffcoaat MK, Jacks TM.  Alendronate  treatment of naturally-occurring periodontitis in beagle dogs.  J Periodontol 1995; 66:211-17. 
  36. Harris ST, Blumentals WA, Miller PD.  Ibondronate and the risk of non-vertebral and
    clinical fractures in women with postmenopausal osteoporosis: results of a meta-analysis of phase III studies.  Curr Med Res Opin 2008; 24:237-45. 
  37. Foundation for Osteoporosis Research and Education: program overview.  Available at
  38. American Association of Clinical Endocrinologists: Clinical Guidelines for the Prevention  
    and treatment of postmenopausal osteoporosis.  www.aace.com
  39. Mohammad AR, Brunsvold MA, Bauer R.  The strength of association between systemic
    osteoporosis and periodontal disease.  Int J Prosthodont 1996; 9:479-83.  
  40. Roberts WE, Simmons KE, Garetto LP, DeCastro RA.  Bone physiology and metabolism
    in dental implantology: risk factors for osteoporosis and other metabolic bone diseases.  Implant Dent 1992; 1:11-21.

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