Could the FRAX TEST for Bone Loss Be Used to Diagnose the Early Signs of Gum Disease?

by | Mar 30, 2015 | Gum disease

Hi everyone,

Are you familiar with a Fracture Assessment Risk Tool?  Chances are probably not if you don’t suffer from repeated bone fractures or osteoporosis or have a family history of osteoporosis.  The Fracture Assessment Risk Tool, or FRAX as it is more commonly referred to, was created by the World Health Organization.  The desire was to help predict the risk of bone fractures related to osteoporosis within the next 10-year span of a patient’s life.  But a recent study from the Case Western Reserve University School of Dental Medicine reveals that the FRAX assessment may also be a helpful diagnostic tool for periodontal disease.


A unique study done by researchers at Case Western in collaboration with the Cleveland Clinic suggests that postmenopausal women susceptible to bone fractures or bone loss may be at a higher risk for periodontal disease and more likely to have symptoms of severe gum disease.  According to Dr. Leena Palomo, DDS, MSD, associate professor of Periodontics and Director of the DMD Periodontics program, the study suggests that this tool is more important to predict women with bone loss who are at a greater risk for gum disease.

In the first decade after the onset of menopause, a woman’s chance of bone loss increases as estrogen levels fall.    Palomo, who’s been researching and analyzing gum disease in post-menopausal women since 2002, says that lower estrogen levels also impact other parts of the body.  The impact of dropping estrogen can be seen in the mouth as well as cause inflammatory changes that can lead to gingivitis, an early signal to periodontal disease.

Since the researchers understood how bone loss occurs throughout the body during menopause, they decided to test the hypothesis that woman at high risk for bone fractures just might be at high risk for periodontal disease too.  So enter the FRAX test scores.  The FRAX needs to account for weight, height, previous fractures, arthritis, smoking habits, diabetes and other factors to make a final assessment.  And wouldn’t you know it; the same factors that the FRAX tool uses to make their bone loss assessment are the same factors dental professionals look at besides an oral exam to diagnose gum disease.

The trial included a sample of 191 women between the ages of 51 to 80 who had gone through menopause within the last ten years.  For the study to be reliable the women could not be on any bone loss medications (like Fosamax or other Bisphosphonates), since the FRAX tool is typically not used on patients who currently receive medicine for osteoporosis.  They also had to be non-smokers and couldn’t be taking any type of hormonal replacement therapies or diabetes medications for at least five years.

All women had a FRAX assessment and a periodontal check-up that measured pocket depth, tooth loss and attachment loss (from the ligaments that connect the tooth to bone).  After the results were calculated the women were placed in two groups: high-risk and low-risk FRAX scores. And not surprisingly, researchers found that women with higher FRAX scores showed the most signs of gum disease.

It seems every day we hear about studies providing in-depth information regarding the relationship between periodontal disease and many other conditions like heart attack, stroke, heart disease and even pancreatic cancer.  Even while more investigative research is needed, results continuously point to the significance gum health can have on your entire physical well-being.  And keep in mind that preventative care at home and at the dentist is the single most effective way to keep gum disease away.

At Dr. Mark W Langberg, DDS, MAGD PC , we keep up with the latest dental research so that we can provide our patients in Southfield, MI and the surrounding area the best dental care available.  While brushing and flossing daily is important, presently nothing can ever take the place of thorough but gentle cleaning at your dentist’s office twice a year (or more for folks with active disease).  If you haven’t had a check-up in a while call us at 248-356-8790 and speak with one of our friendly staff to schedule an appointment or even just a complementary consultation.  Remember a healthy smile not just pretty, it is a gift that keeps on giving!

Until Next Time,

Mark W Langberg, DDS, MAGD
Your Southfield Family Dentist
Tel: (248) 356-8790