Association Between Chronic Periodontal Disease and Obesity: A Systematic Review and Meta‐Analysis

Abstract

Background Obesity is increasing in prevalence and is a major contributor to worldwide morbidity. One consequence of obesity might be an increased risk for periodontal disease, although periodontal inflammation might, in turn, exacerbate the metabolic syndrome, of which obesity is one component. This review aims to systematically compile the evidence of an obesity–periodontal disease relationship from epidemiologic studies and to derive a quantitative summary of the association between these disease states. Methods Systematic searches of the MEDLINE, SCOPUS, BIOSIS, LILACS, Cochrane Library, and Brazilian Bibliography of Dentistry databases were conducted with the results and characteristics of relevant studies abstracted to standardized forms. A meta-analysis was performed to obtain a summary measure of association. Results The electronic search identified 554 unique citations, and 70 studies met a priori inclusion criteria, representing 57 independent populations. Nearly all studies matching inclusion criteria were cross-sectional in design with the results of 41 studies suggesting a positive association. The fixed-effects summary odds ratio was 1.35 (Shore-corrected 95% confidence interval: 1.23 to 1.47), with some evidence of a stronger association found among younger adults, women, and non-smokers. Additional summary estimates suggested a greater mean clinical attachment loss among obese individuals, a higher mean body mass index (BMI) among periodontal patients, and a trend of increasing odds of prevalent periodontal disease with increasing BMI. Although these results are highly unlikely to be chance findings, unmeasured confounding had a credible but unknown influence on these estimates. Conclusions This positive association was consistent and coherent with a biologically plausible role for obesity in the development of periodontal disease. However, with few quality longitudinal studies, there is an inability to distinguish the temporal ordering of events, thus limiting the evidence that obesity is a risk factor for periodontal disease or that periodontitis might increase the risk of weight gain. In clinical practice, a higher prevalence of periodontal disease should be expected among obese adults.

Interleukin-34 Levels in Gingival Crevicular Fluid and Plasma in Healthy and Diseased Periodontal Tissue in Presence or Absence of Obesity: A Clinico-biochemical Study

“…Obesity plays a role in modulating the initiation and progression of periodontal disease. Recent meta-analyses have validated a positive association between being overweight or obese and periodontitis 6,14,27) .…”

A scoping review of the implications of adult obesity in the delivery and acceptance of dental care

“…For this reason dentists need to be aware of implications of managing such patients. Previous studies have attempted to determine the dental need of overweight and obese adults 6,7,8 . Other authors have identified the challenges faced by clinicians when trying to provide safe dental care to this patient group 9,10 .…”

Association between abdominal obesity and periodontal disease. Cross-sectional study.

“…Notwithstanding, one study concluded that PD and abdominal obesity measured by WHR would not be associated 9 . It would be possible to explain this due to ethnic and anthropometric differences in the populations studied.…”

“…During the past few years, it has been described that the nutritional status has a negative effect on periodontal disease (PD) 8,9 , specifying that abdominal obesity would act as a risk factor (10). Due to the impact it generates on the metabolic and immune parameters, susceptibility of the host increases 11,12 favoring progression and severity of the disease.…”