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Number of teeth is associated with hip fracture and femoral neck bone mineral density in the NHANES

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Abstract

Purpose/Introduction

Tooth loss has been found to be associated with fractures and osteoporosis. However, the associations between number of teeth with bone mineral density as well as with hip fractures have not been explored in the same study setting.

Methods

Data from the cross-sectional National Health and Nutrition Examination Survey (2005–2010, 2013–2014, and 2017–2018) with completed femoral neck bone mineral density (BMD) measurements, osteoporosis questionnaires, and dentition examinations were analyzed. A total of 15,198 participants, with a mean age of 53.9 and diverse ethnicity, males (52%), and females (48%), were analyzed. Multivariate logistic regression analyses for self-reported hip fractures, self-reported osteoporosis, and measured low femoral BMD accounting for traditional risk factors were tested for the total number of natural teeth (NoT) present, or by NoT in the anterior or posterior segments.

Results

Subjects with fewer natural teeth present were more likely to report a hip fracture, osteoporosis, or having lower levels of femoral neck BMD. With one additional tooth present in the mouth, there was a decreased association with self-reported hip fracture [OR(95%CI) = 0.98(0.96–0.99); P = 0.005] or with less likelihood of having low femoral neck BMD [OR(95%CI) = 0.99(0.97–1.00); P = 0.007].

Conclusions

With the limitation of the cross-sectional study design, results should be interpreted cautiously, yet our analyses point to an association between a decreased number of natural teeth present and self-reported hip fractures or low femoral neck BMD. The number of teeth present could be potentially utilized for assessing risks of hip fracture and osteoporosis. Future research is needed to validate our findings.

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Acknowledgements

The authors would like to thank the NHANES and its anonymous participants.

Funding

Dr. Yu is supported by the NIH/NIDCR K23DE026804 and the NIH Loan Repayment Program. National Health and Nutrition Examination Survey is a major program of the National Center for Health Statistics, which is part of the Centers for Disease Control and Prevention of the United States. For this study, there is no sponsor for this research.

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Authors and Affiliations

  1. Department of Periodontology, Tufts University School of Dental Medicine, One Kneeland Street, Boston, MA, 02111, USA

    Yau-Hua Yu, Wai S. Cheung & Bjorn Steffensen

  2. Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, 01730, USA

    Donald R. Miller

  3. Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, 02118, USA

    Donald R. Miller

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  1. Yau-Hua Yu
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  2. Wai S. Cheung
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  4. Bjorn Steffensen
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Contributions

Drs. Yu, Cheung, Miller, and Steffensen contributed to study conception, design, data interpretation, and drafting and critical manuscript revision. Dr. Yu downloaded, prepared, and analyzed the NHANES data. All authors gave final approval for the submitted manuscript.

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Correspondence to Yau-Hua Yu.

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Yu, YH., Cheung, W.S., Miller, D.R. et al. Number of teeth is associated with hip fracture and femoral neck bone mineral density in the NHANES. Arch Osteoporos 16, 105 (2021). https://doi.org/10.1007/s11657-021-00970-1

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