Elevated Non-Fasting Plasma Total Homocysteine Level is Associated with Alveolar Bone and Tooth Loss: Insights for Osteogenic Innovations

Abstract

Tooth loss can cause functional impairment, in terms of chewing/mastication ability and choice of foods/diet, leading to malnutrition, which might ultimately impact general health and well-being. No studies on homocysteine (Hcy), an inflammatory sulfur-containing amino acid biomarker, levels, and tooth loss (or number of remaining teeth), are present. This study opted to obtain data from the available National Health and Nutrition Examination Survey III (NHANES III) and perform statistical analysis to investigate the association between tooth loss and tHcy (plasma/serum levels), with a focus on the elderly population. Acquired data for 1568 individuals aged 65 years or older were then tabulated, to detail. Age, gender, cholesterol, income, education, exercise, creatinine, systolic blood pressure, body mass index, and dental state were each found to be independently associated with tHcy. In a multiple regression model, only age (ρ < 0.0001), education (ρ < 0.0001), creatinine (ρ < 0.0001), and dental state (ρ < 0.003) were significantly associated with tHcy, explaining 22% of the variation detected in log-[tHcy]. Plasma Hcy levels in patients are associated with dental status and can be notably affected with oro-dental health, socioeconomic status, and access to therapeutic interventions. Considering these findings, tHcy level monitoring (to diagnose vitamin B6, B9/folate/folic acid or B12 deficiency) as well as nutritional counseling and vitamin supplementation (rechecked post-8 weeks) should be considered and incorporated into the diagnostic and treatment plan for the edentate/edentulous elders, especially if other cardiovascular or inflammatory risk factors are present. In the context of osteogenesis and oral health, research exploring the relationship between elevated Hcy levels and alveolar bone, and tooth loss can provide valuable insights into the underlying mechanisms of bone metabolism and dental health. Understanding how Hcy levels impact bone density, bone remodeling processes, and periodontal health can potentially lead to the design, innovation, development, and translation of novel therapeutic approaches and preventive strategies for osteoporosis, periodontal disease, as well as tooth loss.