No abstract

Numerous cross-sectional epidemiological studies suggest that obesity is associated with periodontal disease. This longitudinal study tested whether body mass index (BMI) was related to the development of periodontal disease in a sample of employed Japanese participants. Data are from the statutory medical checkups routinely collected for employees in and around Nagoya, Japan. The authors tested the relationship between BMI at baseline and the 5-year incidence of periodontal disease in a sample of 2787 males and 803 females. The hazard ratios for developing periodontal disease after 5 years were 1.30 (P < .001) and 1.44 (P = .072) in men and 1.70 (P < .01) and 3.24 (P < .05) in women for those with BMIs of 25-30 and ≥ 30, respectively, compared to those with BMI < 22, after adjusting for age, smoking status, and clinical history of diabetes mellitus. These findings demonstrate a dose-response relationship between BMI and the development of periodontal disease in a population of Japanese individuals.

Cigarette smoking was found to be an independent risk factor for periodontal disease and tooth loss. Alcohol consumption was a limited risk factor for tooth loss in the younger age group, but was unrelated to periodontal disease. To prevent periodontal disease and tooth loss, health practitioners need to encourage people to stop smoking or not to start.

The objective of this study was to assess whether there is a bi-directional relationship between periodontal status and diabetes. Study 1 included 5,856 people without periodontal pockets of ≥ 4 mm at baseline. Relative risk was estimated for the 5-year incidence of periodontal pockets of ≥ 4 mm (CPI scores 3 and 4, with the CPI probe), in individuals with glycated hemoglobin (HbA1c) levels of ≥ 6.5% at baseline. Study 2 included 6,125 people with HbA1c < 6.5% at baseline. The relative risk was assessed for elevation of HbA1c levels in 5 years, with baseline periodontal status, assessed by CPI. Relative risk of developing a periodontal pocket was 1.17 (p = 0.038) times greater in those with HbA1c of ≥ 6.5% at baseline, adjusted for body mass index (BMI), smoking status, sex, and age. Relative risks for having HbA1c ≥ 6.5% at 5-year follow-up in groups with periodontal pockets of 4 to 5 mm and ≥ 6 mm at baseline were 2.47 (p = 0.122) and 3.45 (p = 0.037), respectively, adjusted for BMI, alcohol consumption, smoking status, sex, and age. The risk of developing periodontal disease was associated with levels of HbA1c, and the risk of elevations of HbA1c was associated with developing periodontal pockets of more than 4 mm.

Tooth loss was linked with poorer nutrition even among dentists.