Ecology of alveolar bone loss

The literature is replete with evidence suggesting that, with advancing age, there is an increased alveolar bone loss. However, there is also clinical evidence that not all persons show bone loss with age. This suggests that either (1) there is physiologic bone loss, which means that it is pathologic to have no bone loss with age, or (2) that a few elderly persons without bone loss are well and the majority have pathologic bone loss. Granted that the latter is the more tenable hypothesis, the question is “Why?” Evidence has been presented to show that there is a correlation between local factors and bone loss, irrespective of host state. Data have been offered to show that there is a relationship between host state and alveolar bone loss, irrespective of local challenges. Evidence has been cited to show that the relationship of age and alveolar bone loss is heightened when viewed in the light of both host and local states. However, it should be emphasized that these are only relationships and do not necessarily prove cause and effect. A study has been presented, using vitamin C as the experimental model, to show that the host state may play a causative role in the genesis of alveolar bone loss.