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Osteoporosis

is a bone related disease that occurs when the body loses strength ormakes little bone development. When a patient has osteoporosis, bonesbecome brittle they may break from minor activities such assneezing.Bone remodeling and changes in diet are some of thephysiological causes of osteoporosis (Reid, 2011). Bone strength inadults has to be maintained by the regular removal of a small amountof minerals in the bones the process is called resorption. The lossof bone mineral balance is obtained by equallyadding new mineralsthe failure of balance in the process leads to brittle bones andconsequently osteoporosis. The above process refers to as boneremodeling and closely relates to the pathophysiology ofosteoporosis. Diet also has an influence in the causes ofosteoporosis. If an individual has sudden change in their diet, theyare at a higher risk of osteoporosis. When people are trying to loseweight fast, they do not maintain a balanced diet by avoiding food,which is important for bone strength, thus leading to osteoporosis(Dempster et al., 2013).

is categorized into two behavioral and pathogenic related (Frisk &ampReiner, 2013). Behavioral osteoporosis is caused by risk factors,which are controllable these are the lifestyle related choices. Itis notable that diet that is low in calcium and vitamin D increasesthe chances of an individual developing the condition. Calcium aidsin bone growth and maintenance while vitamin D helps the body toabsorb calciumefficiently. Exercise helps in strengthening bones.Therefore, inactivity results in fragile bones. Smoking and consumingexcessive amounts of alcohol are other factors that contribute tobehavioral osteoporosis. Chemicals found in cigarettes alter thenormal functions of bone cells smoking in women prevents estrogenfrom protecting their bones. Large intakes of alcohol affect anindividual’s body calcium supply. Alcohol consumption should bedone in moderation. There are two pathogenic procedures involved inthe generation of osteoporosis. The attainment of less bone densitywhen a person is young increases the risks of developing osteoporosisand a quick loss of bone density during the menopausal years.

Accordingto the International Foundation, by the year 2000 therewere approximately nine million new fractures related toosteoporosis. Notably, 1.6 million fractures were in the hip, 1.7million in the forearm, and 1.4 million were vertebralbreakages(Nayak et al.,2016 p.1550). Fifty one percent of thesefractures were in Europe and America while forty-nine percenthappened in Southeast Asia and Western Pacific region. The olderpopulations who have ospeorotic fractures are found to die 5-10 yearsafter the injuries (Reid, 2011). Hip and spine fractures contributeto an elevated risk of death and most patients die five yearspost-fracture. Patients with minor fractures and those who diagnosethe condition early are found to have full recovery.

Populationsat Risk

Thereare people who are at a higher risk of developing osteoporosis thanothers due to some unique factors. Malnourished people are amongthose populations at risk in this case,such individuals lack somenutrients. Women with eating disorders, especially anorexia nervosaare at elevated risks, particularly those who weigh 85% of theirappropriate weight (Frisk &amp Reiner, 2013). People whointentionally deny themselves of some nutrients, especially calciumand vitamin D are also at high risks of developing the condition.Diabetics are also most likely to suffer from osteoporosis, andparticularly in type 1 and 2 diabetics. People with type 1 diabeteshave poor bone density it is a possibility that these types ofpatients acquire low peak bone mass since that type of diabetesoccurs at young ages. Patients with type 2 diabetes have increasedbone density however, due to weight problems, which lead toinactivity they are at high risk. Vision problems and nerve damageassociated with diabetics also contribute to increased falls.

Theaged are at a greater risk of osteoporosis as one ages,their bonesweaken. The loss of bone density builds up over time it is acommonmisconception that osteoporosis related with age mainly affectswomen however, it influences both genders. The aged are also athigher risk of developing oral and dental heath related complicationsbecause of the condition. In most cases, females areat a greater riskof osteoporosis than men are. The International Foundation approximates that osteoporosis affects 200 million womenworldwide (Reid, 2011). Females are born with low levels of bonedensity than men, and the bone massdeteriorates as they age. Estrogenis a hormone in women bodies whose availability ensures theregulation of the reproductive system, as well as maintaining healthyand strong bones.As women approach menopause, they are at a greaterrisk of osteoporosis due to a drop in estrogen production.

Hypogonadismis the lack of or a drop in secretion of hormones or any otherphysiological activity of the testes or ovaries (Dempster at al.,2013). In this case, osteoporosis mainly affects men withhypogonadism males with low testosterone levels are at a significantrisk of developing osteoporosis. Interestingly, men also needestrogen for strong and healthy bones those who lack aromatase, anenzyme that converts testosterone to estrogen are at high risk ofosteoporosis. Menopausal women and menstruation history in femalescauses them to be among the populations at risk of osteoporosis. Whenwomen reach menopause, the levels of estrogen dramatically drop byconsidering its importance to the health of bones,it is obvious thatfemales in that stage would be at risk of osteoporosis. Women whoalways had irregular menses were found to be more at risk ofosteoporosis than thosewith regular ones. The length of a menstrualcycle was also a determining factor when considering women at highrisk.

ClinicalSymptoms

Aclinical symptom is an indication of an illness as recognized by thepatient (Reid, 2011).Fractures that occur more easily are the mostcommon symptoms of osteoporosis. Some of the long-term symptomsinclude back pains caused by collapsed vertebra, frequent bonefractures, change in posture, and loss of height. Some of the mostcommon symptoms for osteoporosis include frequent fractures whiledoing basic activities and change in posture.

MedicalTreatments for

Medicaltreatments can be in the form of preventive measures, immediate andlong-term management, medicines, repair of fractures, as well asnon-medicinal treatment (Beaton et al., 2014 p. 290). Preventivemeasures for osteoporosis include avoiding falls, which ensures thatpatients manage the disease. Frequent falls might cause permanentdisability this is commonin elderly patients or diabetics withfailing vision. Immediate measures are taken after a fallthisensures that all fractures are treated in time to avoid furtherdamage and manage the patient’s situation. Long-term measures fortreatment of osteoporosis include the process of a systematiccorrection of fractures and the procedures of demineralization afterresorption.

Thereare other treatments in form of medicine, which includebisphosphonates. This class of drugs when used for osteoporosisalters or ultimately stops the natural process of bone tissuedissolving. This drug is particularly important for women in themenopause stage. Selective estrogen modulators (SERMS) are a class ofdrugs invented for their estrogen benefits (Nayak et al., 2016p.1553). One example of such a drug is Raloxifene, which increasesbone density and lowers cholesterolpost-menopausal women mostly useit. However, bisphosphonates are found to have a link to thedevelopment of osteonecrosis of the jaw. It is recommended that thetreatment is administered orally rather than intravenously

Kyphoplastyattempts to change the kyphosis that occurs because of vertebralcollapse. An instrument is placed in the broken vertebrae to restoreits shape. Vertebroplasty process involves the physical manipulationof a patient’s fracture by placing them on operating tables beforea material is injected in the fracture. Both methods are highlyrecommended to relieve pain. There are other non-pharmaceuticaltreatments, which may involve good nutrition and exercise. As statedearlier, physical inactivity has a negative impact to bone structuretherefore, exercises restore the strength of foods. Eating foods richin calcium and vitamin D is important for bone strength however,this does not mean that individual should ignore other nutrients. Useof manufactured hip protectors also helps to prevent bone fracturing.

Diagnosis

Bonemineral density tests are used to exhibit bone density and are usedto determine the presence of osteoporosis. FRAX is a scientificallyproven risk evaluation tool, whichhas been integrated to anincreasing number of osteoporosis guidelines. The calculatorevaluates a fracture risk in a ten -year period. The FRAX uses thebone mass density of the hipbone since it is a good predictor offuture fractures. Dr. Steve Harris is a clinical professor he saidthat all patients with low BMD should have a complete laboratoryevaluation before treatment (Pickhardt et al., 2016 p. 150). Completeblood count, 24-hour urine calcium and creatinine levels, 25-hydroxy,vitamin D levels, as well as chemistry panel are some of the testssuggested by Dr. Harris. This diagnostic method ensures that allpatients with the condition are found early and can be treated at lowcosts. The dual-energy x-ray absorptiometry (DXA) is the currentcriteria for evaluating body mass density it provides the T-score,which is the BMD value compared with subjects at their peak BMD. AT-score of less than -2.5 indicates osteoporosis while the same scorewith a fragile fracture shows severe osteoporosis the x-ray alsoproduces the Z-score, whichillustratesa value compared with apatient’s age or sex (Dempster et al., 2013). Dental X-rays havealso been found to be very effective in the diagnosis ofosteoporosis the X-rays can clearly distinguish patients with lowbone density from the patients with normal bone density.

Management

Thelifestyle that an individual chooses is optional however, it isimportant to note that the choice will either have negative orpositive effect on health. Lifestyle choices such as exercise, eatingbalanced diets, as well as avoiding alcohol and cigarettes ensurethat a patient easily manages osteoporosis. Avoiding falls is anotherway of managing the disease use of hip protectors and solicitinghelp if there is need to do strenuous activities helps prevent falls.If a fall occurs, it is important to manage it immediately by goingto the hospital to avoid further damage to the bones. Eating balanceddiets rich in protein helps to build body weight low weightincreases the risk of osteoporosis. Eating foods rich in calcium andvitamin D is vital to restore bone strength in patientsgenerally,balanced diets are important for osteoporosis patients.

DentalImplications

tampers with bone strength due to the presence of bones in the jaw,the condition therefore has a direct relationship with dental andoral health. The part of the jawbone that supports the teeth iscommonly referred to as the alveolar process (Frisch and Reiner2013). Research shows that there is a connection between the loss ofthe alveolar and the loss of teeth. The oral effects of osteoporosistends to have more effects in women more than men are, thisespecially applies for women in their menopausal years. Low BMD inthe jaw can lead to other problems such as periodontal diseases andloose-fitting dentures (Reid 2011). Women with osteoporosis arelikely to have loose teeth and may not achieve favorable results evenafter surgical procedures. Periodontitis is an infection where bonesand gums that support the teeth are affected. The loss of teeth is awell-known cause of periodontitis the loss of the alveolar bone’sdensity leaves the bone prone to the bacterium that causes theinfection.

Accordingto the National Institute of Arthritis, Musculoskeletal, and SkinDiseases (NIAMS) dental X-Rays can be used to screen for (Dempster et al 2013). The X-Rays were found to be effective indifferentiating people with normal bone density from the ones withosteoporosis. People visit the dentists more often therefore theyare in a better position to identify people with osteoporosis. Dentalproblems that may indicate low BMD include loose teeth, receding gumsand ill-fitting teeth.

treatments like bisphosphonates have been found to have a link toosteonecrosis of the jaw (Reid 2011). Patients who receive oraltreatments of bisphosphonates have low chances of developingosteonecrosis of the jaw that those who receive the treatmentintravenously.

CareStrategy

Thecare strategy is the plan or actions taken to help patients manage orimprove the condition. Taking mineral and nutritional supplement isin the care plan for patients lack of minerals in the bones causesthem to be weak. Nutritional supplements help patients reach thecorrect nutrient levels needed with the help of food nutrients.Exercise helps strengthen bones, walking is one such activity longperiods of body inactivity weaken the bones. Patients should beencouraged to take part in exercises but be careful to avoidfractures during such activities. Qualified therapists or caregiversshould preferably offer the exercises (Reid, 2011). Using medicinestogether with other strategies also helps to manage the condition.The use of medicines that supplement the estrogen levels and addminerals helps increase bone density. Such drugs include Aleendronate(bisphosphonate) and Raloxifene (SERMS).

Conclusion

Insummation, osteoporosis is a condition where patients have weak bonesor make less development of bone strength. Bone remodeling andchanges in diet are some of the physiological causes of thecondition. is classified into two behavioralosteoporosis that is caused by bad lifestyle choices and pathogenicone that originates from uncontrollable factors. According to theInternational Foundation, by the year 2000, there wereapproximately nine million new fractures related to osteoporosis.Notably, 1.6 million were in the hip, 1.7 million in the forearm, and1.4 million were vertebral fractures. The death rates are found to behigher in aged men and women. Early diagnosis and effectivemanagement helps the patients toattain good recovery rates.Somepopulations are more at risk of osteoporosis than others theyinclude the malnourished, aged, women, diabetics, and people withhypogonadism. Some of the clinical symptoms include fractures, poorposture, and reduction in height. Medical treatment options includetaking preventive, immediate and long-term measures to avoid furtherdamage of bones. Taking drugs, exercising, eating well,vertabroplasty and kyphoplasty are some of the other treatmentoptions for patients. Some of the ways of diagnosing osteoporosisinclude BMD tests, Steven Harris evaluation and X-rays. also causes patients to have weak jawbones, which leads to dentaldiseases and loss of teeth.

References

Beaton,D. E., Dyer, S., Jiang, D., Sujic, R., Slater, M., Sale, J. E. M.,…&amp Fracture Clinic Screening Program EvaluationTeam. (2014). Factors influencing the pharmacological management ofosteoporosis after fragility fracture: results from the Ontario Strategy’s fracture clinic screeningprogram.&nbspInternational,&nbsp25(1),289-296.

Dempster,W. D. Luckey, M. and Cauley, A. J. (2013) .: New York:Academic Press.

Frisch,B. and Reiner B. (2013).OSTEOPOROSIS:Diagnosis, Prevention, Therapy: New York: Springer Science &ampBusiness Media.

Nayak,S., Edwards, D. L., Saleh, A. A., &amp Greenspan, S. L. (2015).Systematic review and meta-analysis of the performance of clinicalrisk assessment instruments for screening for osteoporosis or lowbone density.International,&nbsp26(5),1543-1554.

Pickhardt,P. J., Lauder, T., Pooler, B. D., del Rio, A. M., Rosas, H., Bruce,R. J., &amp Binkley, N. (2016). Effect of IV contrast on lumbartrabecular attenuation at routine abdominal CT: correlation with DXAand implications for opportunistic osteoporosisscreening.&nbspInternational,&nbsp27(1),147-152.

Reid,D. (2011). Handbookon :New York: Springer Science &amp Business Media,