Mandibular bone structure indicates future loss of stature

Iveta Ramonaite, Dental Tribune International

Wed. 23 August 2023

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GOTHENBURG, Sweden: Older age is a major predictor of various health issues, including cognitive and cardiovascular disease, hearing loss and progressive skeletal deformation. Research has also linked older age with height loss, which is associated with increased morbidity and mortality. As the mandibular bone contains ample information about the general bone condition, a recent study has demonstrated that information on mandibular bone structure gained from radiographs during routine dental check-ups may help predict future height loss, thus paving the way for timely prevention.

Height loss in women develops faster over the age of 75. This may be caused by factors such as bone and joint abnormalities, altered posture, compressed or lost discs in the spine and vertebral fractures. According to the study authors, Swedish and Norwegian women have the highest frequencies of fragility fractures in the world. Since height loss carries with it various health risks, they believe that there is a pressing need to develop simple, practical techniques for early identification of the onset or extent of skeletal degeneration in older adults.

In the study, the researchers employed data on 937 Swedish women born between 1914 and 1930 (middle-aged and elderly at baseline), drawn from the Prospective Population Study of Women in Gothenburg. They assessed their mandibular cortical erosion and trabecular sparseness and calculated their height loss over three periods: 1968–80, 1980–92 and 1992–2005. Each participant had undergone health and dental check-ups at least twice during the monitoring period.

The study reported that the participants annually lost 0.075 cm, 0.08 cm and 0.18 cm, respectively, over the three observation intervals. This resulted in 0.9 cm, 1.0 cm and 2.4 cm in total for all three periods. The study also demonstrated that the percentage of women with severe cortical erosion rose from 3.2% in 1968–80 to 11.1% in 1980–92 and up to 49.8% in 1992–2005. Similarly, the prevalence of sparse trabeculation increased from 20.6% in 1968–80 to 33.5% in 1980–92 and up to 41.6% in 1992–2005. In each period, height loss was greatest in those with severe cortical erosion and those with sparse trabeculation and significantly predicted height loss over the next 12–13 years.

The researchers acknowledge that the study is observational and has some limitations. Therefore, no firm conclusions can be drawn yet. However, they noted that the structural bone changes seen in the jawbones of the study participants resemble those of the vertebrae, which could explain height reduction. “[These changes] may therefore serve as proxy indicators when screening in the early phases of bone degenerative pathogenesis, signalling the ongoing bone remodelling and the need for further clinical attention to older women at risk of height loss,” the authors noted.

“Since most individuals visit their dentist at least every two years and radiographs are taken, a collaboration between dentists and physicians may open opportunities for predicting future risk of height loss,” they concluded.

The study, titled “Does mandibular bone structure predict subsequent height loss? A longitudinal cohort study of women in Gothenburg, Sweden”, was published online on 4 July 2023 in BMJ Open.