What Is Bone Tissue and How Does It Support Your Teeth?

Have you ever thought about how people manage to stand, run, jump, and even protect their most important organs? All of this is possible thanks to the bones. Bones form the skeleton—the structure that gives bodies shape and support. But bones do much more than that: they also protect organs like the brain and heart and even help produce blood cells.

Although bones seem hard and rigid, they are much more complex than they appear. Bones are made from an amazing mix of materials: collagen fibers, which are flexible like rubber bands, and strong minerals like calcium and phosphorus, which provide strength. This combination makes bones firm but also a little flexible—great for preventing them from breaking easily. Did you know that, in addition to holding the body upright, bones are also super important for the health of your teeth? Yes, your jawbone and the alveolar bone—the bone that surrounds the teeth—are essential for keeping your teeth firm and in place. Just like other bones in the body, they need care to stay healthy!

Bones have two main parts: a compact part, which is tough and sturdy, and a spongy part, which is lighter and full of tiny spaces, like a sponge. The spongy part helps absorb impacts when you jump or run, and in the case of the mouth, it helps keep the teeth stable and protected. Bones also have protective layers. The periosteum is an outer layer that nourishes and helps heal bones when they get injured. The endosteum lines the inside of the bone. And in the center of some bones, there is bone marrow, an incredible factory where blood cells are produced so they can circulate throughout the body—including the white blood cells, which help fight infections, including infections in the mouth [1].

Inside the bones, there are several types of important cells (Figure 1). Some cells monitor and keep everything in order, and others remove old parts of the bone to make room for new, healthy ones. This process happens in the bones of the mouth as well, and when the health of the alveolar bone is not properly cared for, bone loss can occur. This a common problem in diseases like periodontitis—a gum infection that, if left untreated, can affect the bones around the teeth.

Osteoblasts: The Bone Builders

Osteoblasts are important cells responsible for building and renewing bones, keeping them strong and healthy. Osteoblasts first produce osteoid, a soft and fragile substance, then they add calcium and phosphate to this base, transforming it into a strong and solid bone. Once they finish their building job, osteoblasts have three options: they can transform into osteocytes, which monitor and perform small repairs on the bone; they can remain on the bone’s surface to protect it; or they can “retire” and stop working.

Osteoblasts also help control osteoclasts, the cells responsible for “taking apart” bone. This control is important to keep the balance between building and removing bone. Osteoblasts produce a molecule called RANKL, which works like a key (Figure 1). This key fits into a lock on the surface of osteoclasts and, when that happens, they are activated to break down the bone. Osteoblasts can also produce osteoprotegerin (OPG), a molecule that acts like a blocker. It prevents the key (RANKL) from fitting into the lock (RANK). When there is more OPG, osteoclasts become less active and bones stay strong and dense. When there is too much RANKL, osteoclasts work more than they should, causing bone loss [2].

This interaction is also very important for the health of your teeth! The jawbone and alveolar bones depend on osteoblast activity to stay strong and healthy. If osteoblasts do not function correctly, the bone structure around your teeth can weaken, potentially leading to tooth loss.

Osteocytes Keep Your Bones Strong and Healthy

Osteocytes make up around 95% of bone cells. They start as osteoblasts, but once they are trapped in the bone as it hardens, they form a network with other bone cells. Osteocytes act like sensors, detecting any changes in the bone—whether it is from physical forces or chemical signals—and send messages to other bone cells (such as osteoblasts and osteoclasts) to help maintain bone strength and health based on what the body needs.

Osteoclasts: The Demolishers

Think of osteoclasts as the “demolition experts” in your bones. They only start working when osteoblasts send them a signal. Once activated, osteoclasts release acids and enzymes to break down old bone and release important minerals like calcium into the bloodstream. After this, osteoblasts rebuild by creating fresh bone tissue. This constant process of breaking down and rebuilding bone ensures your bones stay strong and adaptable. If osteoclasts work too much, bones can become weak (like in osteoporosis), but if they do not work enough, bones can grow abnormally and become too hard (as also happens in osteopetrosis) [3]. Balance is the key!

How Strong Bones Form and Grow

Ever wondered how bones are made? Now we will take a closer look at two processes that shape bone growth and how growth hormone (GH) plays a role in keeping bones strong. One way that bones form is called direct bone formation. This is how bones like those in your skull form. In this process, a special tissue called mesenchyme turns into bone, with the help of osteoblasts. The second method of bone formation is called bone formation from a cartilage base. This process forms long bones like those in your arms and legs. A cartilage mold is created first, then slowly turns into bone, helping bones grow longer.

Bones are always growing and changing, but they need a little help to become stronger. That is where GH comes in! Think of GH as the “coach” that tells your bones, “It is time to grow”! Produced by your brain, GH gives the green light to the bone-building osteoblasts, telling them to start working—creating new bone tissue and making your bones longer and stronger. GH also makes your liver produce something called insulin-like growth factor-1 (IGF-1), a powerful ally that further boosts bone growth [4].

Throughout your life, your bones are always remodeling, like a construction site that never stops working. Your body is constantly balancing two tasks: building new bone tissue and removing the old to keep everything strong, renewed, and in great shape [5]. This is how your bones stay ready to support you while you grow, run, jump, and stay active!

Dental Bone Loss: the Battle for Tooth Health

Imagine your teeth are like castles, and the alveolar bone is the foundation that keeps them strong and secure. What happens if that foundation begins to weaken? Periodontitis is like an invisible enemy attacking the base of your permanent teeth, destroying the “foundation” that holds them in place (Figure 2). It all starts with something simple: bacterial plaque—a sticky film that forms on your teeth and, if not removed, begins to accumulate bacteria. These bacteria release toxins that cause inflammation in the gums and, over time, attack and destroy the alveolar bone that anchors your teeth in your jaw. The result? Your teeth begin to loosen, may shift out of place, or even fall out.

Now you might be wondering, “How can I prevent this from happening”? The good news is that prevention is super simple! Maintaining good oral hygiene—like brushing your teeth regularly, flossing, and visiting the dentist for check-ups—are the key steps to protecting your bone foundation and increasing the chances your teeth stay firmly in place. It is also important to follow a healthy diet and maintain a balanced lifestyle. This helps keep your bones strong and resilient, protecting your teeth from the dangers of periodontitis.

Bones are much more than structures that support the body—they are living tissues that are constantly renewing themselves with the help of key cells, such as osteoblasts, osteoclasts, and osteocytes, as well as GH. In the mouth, the alveolar bone supports the teeth, working as a firm base. When you take good care of your oral health by brushing your teeth, using dental floss, eating healthy foods, and visiting the dentist, you also protect this bone and keep your teeth strong. Bone health and oral health are connected and depend on balance, teamwork among cells, and a bit of daily care. Understanding how bones work and how to take care of them is essential for keeping a strong and healthy smile throughout life.

Glossary

Alveolar Bone: ↑ The part of the jawbone that holds the roots of the teeth in place.

Periodontitis: ↑ A disease that makes the gums and bones around teeth weak and can cause teeth to loosen or fall out.

Osteoblasts: ↑ Cells responsible for building new bones.

Osteocytes: ↑ Cells that live inside bones and signal when repair is needed.

Osteoclasts: ↑ Cells that break down old bone to make room for new bone.

Osteoporosis: ↑ A condition where bones become weak and break easily because they lose minerals like calcium.

Growth Hormone (GH): ↑ A natural substance made by the body that helps bones and muscles grow.

Bacterial Plaque: ↑ A sticky film made of bacteria that forms on teeth and can cause cavities and gum problems.

Conflict of Interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

Financial support from FAPESP (2021/09272-0), CNPq (PIBIC-EM) and CAPES Foundation (financial code 000).

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