Effects of Bariatric Surgery on the Oral Health of Patients

Abstract

Objective: The objective of this prospective cross-sectional study was to analyze the effects of bariatric and metabolic surgery on the oral health of patients.Methods: Twenty-nine patients answered a questionnaire after undergoing bariatric surgery. Of these,18 accepted to have their dental condition clinically assessed as well. Mean postoperative time was 4 years. Oral and eating habits were assessed in order to detect the impact of gastroplasty on patients' lives and on their dental status. The Eccles index was usedto assess the level of dental erosion.Results: Bariatric surgery complications such as gastroesophageal reflux (55%), induced vomiting (90%), anxiety (65%), and systemic diseases such as anemia, high blood pressure, allergies or a combination of these (59%) were observed. Additionally, changes in eating habits such as craving for candies, ice, beer, finger foods, and sodas (59%), as well ashyposalivation (27%), parafunctional habits (55%), and dentin sensitivity (48%) were also reported. Among the patients submitted to the clinical examination, 55% demonstrated caries and 28% tooth wear Grade 1. Conclusion:Bariatric surgery had a negative effect on oral health, making the patient more susceptible to dental erosion. The integration of dentists into multidisciplinary teams is essential to early diagnosis and treatment of injuries caused by dental erosion. Dentists' awareness of the effects of bariatric surgery on the oral health can assist them to improve the quality of life of bariatric patients.

The influence of systemic condition and medications on alveolar bone loss and tooth attrition

“…All studies except two depicted an association between obesity and periodontal disease [47]. Although no studies directly correlate obesity to tooth wear, few reports that in morbid obesity, reduced unstimulated and stimulated salivary ow can be observed, thus increasing the risk of tooth wear and erosion [48,49].…”

The effect of bariatric surgery on periodontal health: systematic review and meta-analyses

“…The most commonly performed BS procedures are laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass [6]. BS has many already recognized negative sequelae for oral health, such as an increase in severity of tooth erosion, hypersensitivity of the teeth, and the number of carious lesions [7,8]. Most of the observational studies evaluating patients before BS report a high prevalence of periodontitis (between 50% [9] and 70% [10]), which corroborates the observation that obesity is a risk factor for periodontitis [11].…”

“…The temporarily consistent increase in CAL, PPD and % PPD 4-5 mm as observed 6 months after BS, but not 12 months after BS, may indicate that during recovery from BS, patients experience progression of periodontal destruction that might be reversible. The noted changes in the periodontal condition could be a consequence of BS complications such as gastroesophageal reflux and vomiting [7], malnutrition [29], postoperative inflammation [30], gut microflora change [31], osteoporosis, and prolonged disbalance of white cell function after BS [32]. Also, frequent meals (5 times a day), and consummation of soft, plaque-promoting food in the first months of recovery from BS, could negatively affect periodontal tissues [9].…”