Bone loss and oral state in patients on home parenteral nutrition

The purpose was to analyze changes in the mandible and the forearm bone mineral content and oral state in patients on home parenteral nutrition due to short bowel syndrome in relation to the bone mineral values and oral findings in a normal population.

The bone mineral content was measured by dual-photon absorptiometry and the dental and periodontal state were studied in 15 adults patients (12 women, and 3 men, aged 26 to 65 years). All patients were on free oral intake as a supplement to the parenteral nutrition.

Forty-seven percent of the patients (2 males, 2 young and 3 elderly females) showed mandibular osteoporosis (Z-scores < -2.00), and all young females showed Z-scores < 0. Moreover, 34% of the patients showed osteoporosis in the forearm bones (Z-scores < -2.00) and also radiographic signs of osteoporotic fractures of the columna. The dental and the periodontal state in the patients did not differ clearly from that of the normal Danish population of the same age.

Such patients seem to have a high risk of developing systemic osteoporosis, including the jaws, but apparently do not show a higher risk for deterioration of the dental or periodontal state than age-matching normals from the same population.