Effect of Periodontitis and Toothbrushing Frequency on Obesity Onset: A Cohort Study

Abstract

Background: The interplay between obesity and periodontitis has been widely examined. While obesity was reported as a risk factor for periodontitis, the inverse relationship is still little explored. Therefore, we aimed to determine whether periodontitis and toothbrushing frequency affect the onset of obesity. Material/Methods: This cohort study included 1619 employees of a business enterprise headquartered in Tokyo, who in 2002 and 2006 underwent in prescribed annual health checks, both general and dental-specific, and who were not obese in 2002 (body mass index <25). The response variable was obesity (or absence) at 4 years, while the explanatory variables were presence/absence of periodontal pockets and toothbrushing frequency in 2002; their relationships were examined by multiple logistic regression analysis. Results: Subjects with periodontal pockets ³4 mm showed a significantly higher odds ratio (OR) for onset of obesity at 4 years than those without periodontal pockets [OR: 1.59, 95% CI (confidence interval): 1.08-2.35, p<0.05]. Similarly, subjects who brushed their teeth ³3 times/day had a significantly lower obesity OR than those who brushed £1 time/day (OR: 0.49, 95% CI: 0.28-0.85, p<0.01). Conclusions: The presence of periodontal pockets and toothbrushing frequency are significantly associated with the onset of obesity. Periodontal pockets ³4 mm are associated with increased risk of obesity, while frequent toothbrushing (³3 times/day) appears to reduce the risk of obesity.

Associations with oral health indices for obesity risk among Japanese men and women: results from the baseline data of a cohort study

“…Even if those with dry mouth due to diabetes were excluded, dry mouth was found to be more common in middle-aged and older people. For an increased risk of obesity, in the current study, our findings on oral self-care habits in men and women were supported by results from previous studies [14,35], but we might not have found significant associations with oral hygiene. Surprisingly, a variety of OHIs and a series of oral health questions (e.g., our 15 questions) including "tooth brushing frequency" have not been examined in relation to risks of obesity, diabetes, cardiovascular diseases, and hypertension in many previous studies in Japan and American-European countries.…”

“…Multivariable adjusted logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for obesity, compared with each 15 question on oral health (good as "reference") and each five OHI (the lowest tertile as "reference"). With reference to previous studies [6,14,31], the potential confounding factors were applied as follows: age (years), physical activity (METs‧h/day), total energy intake (kcal/ day), and tooth number (n) as continuous variables, and current smoker (no/yes = 0 / 1), current habitual drinker (no/yes = 0 / 1), snacking (none/sometimes/everyday = 1 / 2 / 3), education level (< 12 / 12 / > 12 years = 1 / 2 / 3), medications [no/yes = 0 / 1 for diabetes, dyslipidemia, hypertension, angina myocardial infarction, and cerebral stroke, respectively] and tooth/gum conditions [no/ sometimes/yes = 1 / 2 / 3 for tooth pain, gum bleeding, and gum swelling, respectively] as categorical variables.…”

Lifestyle Risk Factors and the Population Attributable Fractions for Overweight and Obesity in Chinese Students of Zhejiang Province

“…There are few studies addressing the associations between oral health and the risk of obesity, especially in children. A cohort study in Japanese adults found that brushing teeth frequently (>3 times/day) may reduce the risk of obesity (OR: 0.49, 95% CI: 0.28–0.85) ( 36 ). Our study expands previous findings and showed that unhealthy toothbrushing habit was also a risk factor for overweight/obesity in students.…”

Association between diabetes-related clinical indicators and oral health behavior among patients with type 2 diabetes

“…Recently, Morita et al reported a significant association between toothbrushing frequency (≥ three times / day) and onset of obesity in a 4-year cohort study of individuals who were not obese (BMI < 25kg / m 2 ) at baseline (15). They concluded that people who brushed their teeth frequently (i.e., had good toothbrushing practices) are at low risk of becoming obese.…”