FAQ: What Skeletal and Dental Manifestations Might Indicate HPP?

April 2026

In this educational FAQ video, Jeremy Morgan, NP, of Access Solutions Rheumatology in Tulsa, Oklahoma, explores the key skeletal and dental manifestations associated with hypophosphatasia (HPP), a rare metabolic bone disease that is often under recognized in clinical practice. This overview highlights important dental findings such as recurrent cavities, early tooth loss, frequent fillings, crowns, and root canals, which may serve as early indicators of HPP. On the musculoskeletal side, patients commonly present with chronic foot pain, shin pain, enthesitis, and frequent stress fractures—often going unnoticed due to persistent discomfort. Many individuals are misdiagnosed with conditions like fibromyalgia or osteoporosis at a young age, and notably, treatment with bisphosphonates may worsen bone health in patients with HPP. This video provides valuable clinical insights for rheumatology providers and advanced practice providers to help improve early recognition, avoid misdiagnosis, and optimize management of hypophosphatasia. For more rheumatology-focused education, visit the RhAPP Content Rheum and RhAPP ACE app.