Can the FRAX tool be a useful aid for clinicians in referring women for periodontal care?

Alli, Foluke; Bhandal, Gazabpreet K.; Thacker, Holly L.; Palomo, Leena

doi:10.1097/gme.0000000000000272

Cited by 5 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FRAX involves several clinical risk factors to predict the skeletal condition (Kanis et al 2013). The association of severe periodontal disease with low BMD or FRAX was reported previously (Alli et al 2015).…”

Section: Discussionmentioning

confidence: 89%

Effects of Bone Fragility and Antiresorptive Drugs on Periodontal Disease and Tooth Loss: A Longitudinal Study

Penoni

Leão

Torres

et al. 2018

JDR Clinical & Translational Research

View full text Add to dashboard Cite

This longitudinal study aimed to elucidate whether systemic bone fragility predicts severe periodontal clinical attachment loss (CAL) and tooth loss over the years and to test the influence of bone medication and periodontal maintenance in these relationships. Elderly women were evaluated for bone mineral density (BMD) and for fracture risk assessment (FRAX) in a cross-sectional analysis and retrospective follow-up (6-and 10-y periods). Data on BMD and FRAX were used as indicators of bone fragility in structural equation modeling. Periodontal examination and data on postmenopausal tooth loss were recorded. Multivariate Poisson regression models with robust covariance were used to estimate relative risk (RR) and 95% CI of BMD and FRAX for sites with CAL ≥6 mm and for tooth loss. The cross-sectional analysis included 134 women aged 65 to 80 y, and from them 71 and 49 women had available data for analysis in the 6-and 10-y follow-up periods, respectively. Bone fragility predicted severe CAL over 10 y (e.g., femoral neck: 10-y analysis, β = −0.389, P = 0.005; cross-sectional, β = −0.190, P = 0.004); however, this association did not remain significant when the use of bone medication was evaluated. Poisson regression showed that a better skeletal condition was associated with a lower risk of severe periodontal disease and tooth loss (cross-sectional femoral neck: RR = 0.08, P < 0.001; RR = 0.03, P < 0.001, respectively) when not adjusted for bone medication and periodontal maintenance. The receiver operating characteristic curve suggested that women with osteoporosis should be referred for periodontal assessment (sensitivity = 71.0%, specificity = 70.0%). Bone fragility is a relevant longitudinal predictor of severe periodontal disease and tooth loss among elderly women. The use of bisphosphonates improved the bone condition as well as the periodontal status. Periodontal maintenance also minimized the negative impact of low BMD on teeth-supportive tissues in the studied population. Knowledge Transfer Statement: The results of this study present evidence that the management of bone fragility and osteoporosis may be important in the prevention of periodontal attachment loss and future tooth loss. Besides the antiresorptive effects of the antiosteoporosis drugs on systemic bone conditions, these medications may protect periodontal tissues. The interaction of health care professionals such as dentists and physicians

show abstract

Section: Discussionmentioning

confidence: 89%

Effects of Bone Fragility and Antiresorptive Drugs on Periodontal Disease and Tooth Loss: A Longitudinal Study

Penoni

Leão

Torres

et al. 2018

JDR Clinical & Translational Research

View full text Add to dashboard Cite

show abstract

“…Several studies have focused on the association between chronic periodontitis and osteoporosis, and systematic reviews indicate that postmenopausal women with osteopenia or osteoporosis have more severe periodontitis [ 5 , 6 ]. Higher FRAX scores have been associated with impaired periodontal status in postmenopausal women [ 7 ], and Penoni et al also found in a later study that periodontal disease was not a predictor for osteoporosis, although FRAX was “a useful tool to suggest periodontal evaluation” [ 8 ]. In another study, Priebe et al found an association between the number of missing teeth, hip fractures, and a FRAX assessment of fracture risk [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Patients’ thoughts about assessment of fracture risk in a dental setting using FRAX—a qualitative interview study

et al. 2023

View full text Add to dashboard Cite

Summary FRAX is a tool based on questions that identifies persons at risk of fragility fractures. We interviewed patients about their thoughts on doing FRAX in a dental setting. They were generally positive but had some concerns that need to be considered before introducing FRAX in a dental setting. Purpose To investigate patients’ thoughts about assessing the risk of fragility fractures using the FRAX tool in a dental setting. Sweden has a high incidence of fragility fractures, but many of these are preventable. The most common method for identifying persons with a high risk of sustaining fragility fractures is FRAX, a validated instrument for assessing the risk of suffering fragility fractures within 10 years. In the Nordic countries, most of the adult population has regular contact with their dentist, which could be useful in identifying high-risk individuals. Methods A qualitative inductive approach to content analysis, with individual semi-structured interviews, was used. Seven women and three men, aged 65–75 years, were interviewed and assessed with FRAX. Results An overarching theme was that patients considered a FRAX assessment in the dental setting a good service but doubted that the dentists would have the interest, time, and knowledge to do it. The patients had little knowledge and experience of osteoporosis and fragility fractures. They were positive towards assessing the fracture risk with the FRAX instrument. If they were found to have a high fracture risk, they expected the dentist to send a referral for further investigation and to collaborate in the risk assessment with their family physician. They thought risk assessment in a dental context would be a good service if the fee was the same as that in primary care. Conclusion Most participants were positive about having FRAX and other health assessments done in the dental clinic, but this study shows that patients have concerns that need to be addressed before introducing FRAX in this context.

show abstract

Untreated osteoporosis and higher FRAX as risk factors for tooth loss: a 5-year prospective study

et al. 2023

View full text Add to dashboard Cite

Can the FRAX tool be a useful aid for clinicians in referring women for periodontal care?

Cited by 5 publications

References 20 publications

Effects of Bone Fragility and Antiresorptive Drugs on Periodontal Disease and Tooth Loss: A Longitudinal Study

Effects of Bone Fragility and Antiresorptive Drugs on Periodontal Disease and Tooth Loss: A Longitudinal Study

Patients’ thoughts about assessment of fracture risk in a dental setting using FRAX—a qualitative interview study

Untreated osteoporosis and higher FRAX as risk factors for tooth loss: a 5-year prospective study

Contact Info

Product

Resources

About