# Anti-resorptive therapy for osteoporosis and oral status of geriatric inpatients: A retrospective hospital-based study

## TL;DR

This study found that older patients undergoing osteoporosis treatment often experience tooth loss during hospitalization due to oral infections.

## Contribution

The study identifies age as a significant predictor of tooth extraction in geriatric patients undergoing bisphosphonate therapy.

## Key findings

- Patients aged 85 and above had a 2.6-fold higher likelihood of tooth extraction.
- The average number of teeth decreased slightly during hospitalization.
- 45 out of 161 patients underwent tooth extraction due to oral infections.

## Abstract

In osteoporotic patients, eliminating any sources of oral infection is recommended prior to initiating bisphosphonate (BP) therapy, as a preventive strategy against medication-related osteonecrosis of the jaw (MRONJ). Given their current state oral health status, oral disinfection before BP therapy for osteoporosis may frequently result in teeth extraction in geriatric hospitalized patients.

The study purpose was to determine whether the number of teeth of geriatric hospitalized patients undergoing BP therapy for osteoporosis declined during their hospital stay. A retrospective study was conducted on medical records of patients over the age of 65 who were hospitalized at the Rothschild Hospital (Assistance Publique-Hôpitaux de Paris, Sorbonne Université) and referred to the Oral Surgery Department for the detection of oral infectious foci prior to initiating antiresorptive therapy, from September 2021 to July 2022. The primary outcome measured was teeth number, recorded before the start of antiresorptive therapy and at hospital discharge. Data were analyzed by using a paired t-test, one-way ANOVA, and binary regression analysis, with statistical significance set at P<0.05.

Among the study population (n=161 subjects, 120 women, mean age of 86.1±6.7 years), 84 subjects (52.1%) had oral infections foci and 45 subjects (27.9%) benefited from teeth extraction during the course of their hospitalization. Binary logistic regression showed that being aged 85 and above was a significant predictor of teeth extraction (p<0.05), with an odds ratio of 2.63 (95% CI: 1.14-6.03). The average number of teeth significantly decreased from 16.1±9.6 to 15.4±9.7 (student t-test, p0.05, ddl= 160) during the course of the hospitalization.

A decline in the number of teeth was observed during hospitalization. Patients aged 85 and above had a 2.6-fold higher likelihood of tooth extraction during hospitalization than younger patients.