Association between remaining teeth and femoral neck bone mineral density in patients undergoing dialysis

Assessing bone mineral density and implementing fracture prevention measures are useful in managing dialysis patients. This study aimed to assess oral health, including the number of remaining teeth, and to investigate factors associated with the young adult mean (%YAM) of the femur and lumbar spine in this population.

This cross-sectional study included 110 patients who initiated dialysis treatment at our hospital and underwent panoramic radiography, oral assessments and dual-energy X-ray absorptiometry (DXA) scans of the femur and lumbar spine within one month. Associations between oral health and YAM were examined using univariate and multivariable analyses, with the latter focusing on femoral YAM because of potential artefacts affecting lumbar measurements.

In the univariate analysis, femoral YAM was significantly associated with sex (B = -21.62, p < 0.001), body mass index (BMI; B = 1.926, p < 0.001), and the number of remaining teeth (B = 0.388, p = 0.026). However, in the multivariable analysis, the final model did not include the number of remaining teeth. BMI (B = 1.12, p = 0.005) and sex (B = -18.49, p < 0.001) remained significant factors, with sex showing the strongest association.

In incident dialysis patients, fewer remaining teeth were associated with lower femoral YAM in univariate analysis, but this association was not independent of age, sex and BMI in multivariable analysis. Tooth loss may therefore reflect the cumulative effects of these factors rather than representing an independent predictor of bone mineral density.