Indian Journal of Endocrinology and Metabolism

LETTER TO THE EDITOR
Year
: 2014  |  Volume : 18  |  Issue : 6  |  Page : 871-

Call for detection of osteoporosis in India-can a dentist help?


Pradeep Kumar, Saumyendra Vikram Singh, Himanshi Aggarwal, Habib Ahmed Alvi 
 Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Himanshi Aggarwal
Room No. 404, E Block, Gautam Buddha Hostel, KGMU, Lucknow
India




How to cite this article:
Kumar P, Singh SV, Aggarwal H, Alvi HA. Call for detection of osteoporosis in India-can a dentist help?.Indian J Endocr Metab 2014;18:871-871


How to cite this URL:
Kumar P, Singh SV, Aggarwal H, Alvi HA. Call for detection of osteoporosis in India-can a dentist help?. Indian J Endocr Metab [serial online] 2014 [cited 2021 Jan 25 ];18:871-871
Available from: https://www.ijem.in/text.asp?2014/18/6/871/141391


Full Text

Sir,

Apropos the editorial recently published on call for action for osteoporosis in India. [1] Varthakavi et al. have rightly mentioned that we are lagging far behind in terms of diagnosis of osteoporosis; reasons being limited access and availability of dual energy X-ray absorptiometry (DXA) machines and increased cost of DXA scan. Since osteoporosis is preventable, diagnostic techniques are of major importance. [2] Osteoporosis is characterized as a significant age-related deficiency in bone mass with a potential for structural failure, affects a large portion of the elderly population. Besides the persisting systemic bone loss, oral manifestations such as alveolar ridge resorption, tooth loss, periodontal disease and oral bone loss could also be associated. [3] This letter proposes that dentist can play a role of importance in cost-effective and accessible screening of osteoporosis.

The dentist is often the most regularly visited doctor by the elderly population, and dental radiographs are the most frequently used imaging modalities for these patients. Panoramic radiographs are widely used in dental practice for the diagnosis of dental pathologies. It is possible for dentists to evaluate patients' osteoporotic status from these radiographs. [3] The application of panoramic radiographs for bone density studies was analyzed by Southard (1992), Klementti (1993 and 1994), Taguchi (1995) and Bollen (2000). A number of indices, image processing and analyzing techniques based on panoramic radiographs have been developed to discriminate individuals with and without osteoporosis. [4] Cortical width, panoramic mandibular index, alveolar crest resorption degree (M/M) ratio, cortical index and fractal dimension are a few among them. [4]

Since it has been established that the decreased bone mineral density affects morphometric, densitometric and architectural properties of mandibular bone in osteoporotic patients; panoramic radiograph may give an economical and reliable diagnostic tool option to rule out osteoporosis/osteopenia in undiagnosed patients. This method would be convenient and fast, with low irradiation dose.

Mithal et al. have mentioned that various aspects of osteoporosis are a component of training for orthopedic surgeons, gynecologists, rheumatologists, and rehabilitation medicine physicians, apart from endocrinologists. [5] We advocate that this disease should be a training component for dentists as well because of its implications. The role of the dentist needs to be emphasized as the elderly are at a high risk of osteoporosis and frequently need dental consultation. There is an urgent need for greater public and medical fraternity awareness in this regard, as early detection and treatment of osteoporosis would reduce the associated morbidity and mortality.

References

1Varthakavi PK, Joshi AS, Bhagwat NM, Chadha MD. Osteoporosis treatment in India: Call for action. Indian J Endocrinol Metab 2014;18:441-2.
2Link TM, Majumdar S, Grampp S, Guglielmi G, van Kuijk C, Imhof H, et al. Imaging of trabecular bone structure in osteoporosis. Eur Radiol 1999;9:1781-8.
3Güngör K, Akarslan Z, Akdevelioglu M, Erten H, Semiz M. The precision of the panoramic mandibular index. Dentomaxillofac Radiol 2006;35:442-6.
4Watanabe PC, Issa JP, Oliveira TM, Monteiro SA, Iyomasa MM, Regalo SC, et al. Morphodigital study of the mandibular trabecular bone in panoramic radiographs. Int J Morphol 2007;25:875-80.
5Mithal A, Bansal B, Kyer CS, Ebeling P. The Asia-Pacific regional audit-epidemiology, costs, and burden of osteoporosis in India 2013: A report of international osteoporosis foundation. Indian J Endocrinol Metab 2014;18:449-54.