Association of long‐term obesity and weight gain with periodontal pocketing: Results of the Northern Finland Birth Cohort 1966 study

Abstract

Aim: To investigate whether obesity, central obesity, and weight gain are associated with periodontal pocketing. Materials and methods:A never-smoking sub-population (n = 725) of the Northern Finland Birth Cohort 1966 was categorized based on body mass index (BMI; participants with normal weight, overweight, and obesity) and waist circumference (WC; participants without central obesity and with central obesity) at ages 31 and 46. The categories were combined to define whether the participants stayed in the respective BMI and WC categories or moved on to a higher category during follow-up. A periodontal examination was done at age 46.Results: WC was more consistently associated with periodontal pocketing than BMI.The relative risks for the number of sites with periodontal pocket depth (PPD) ≥4 mm and bleeding PPD ≥4 mm in participants with central obesity both at age 31 and at age 46 were 1.7 (95% confidence interval [CI] 1.4-2.0) and 2.1 (95% CI 1.6-2.6). The corresponding values for participants who had no central obesity at age 31 but had central obesity at age 46 were 1.6 (95% CI 1.4-1.8) and 1.9 (95% CI 1.6-2.3). Conclusion:Of all the studied measures, central obesity appeared to be most strongly associated with the inflammatory condition of the periodontium.

Association of obesity and weight gain with alveolar bone loss: Results of the Northern Finland Birth Cohort 1966 study

“…We interpreted the latter to mean that glucose metabolism, as suggested by Genco et al (2005), could be one mechanism through which obesity exerts its effects on the periodontium. This is also in line with our earlier finding of an association between impaired glucose metabolism and periodontal pocketing (Tegelberg et al, 2021). Altogether, the stability of the RRs after adding the above covariates into the models supports the credibility of the findings (Table S5).…”

“…The data on socio-demographic and health behaviour were collected using a questionnaire at age 46 and categorized as described earlier (Tegelberg et al, 2021). In short, education was categorized into three categories: basic, intermediate and high (ISCED, 1997).…”

“…We recently reported that obesity and weight gain are associated with deepened periodontal pockets (Tegelberg et al, 2021). This finding is in line with several earlier longitudinal studies (Gorman, Kaye, Apovia, et al, 2012; Jimenez et al, 2012; Morita et al, 2011; Saxlin et al, 2010) in which an association between obesity and periodontal pocket formation has been found.…”

Mendelian randomization highlights the causal association of obesity with periodontal diseases

“…Yet, inconsistent results were reported in prospective cohorts. Several longitudinal studies reported a higher incidence and progression of periodontitis in overweight individuals compared to normal weight individuals (Morita et al, 2011;Gorman et al, 2012;Jimenez et al, 2012;Tegelberg et al, 2021), whereas some others did not find similar associations (Saxlin et al, 2011;de Castilhos et al, 2012). It appears that longitudinal studies with long-term follow-up (≥20 years) can provide more evidence that supports the positive association (Keller et al, 2015).…”

“…BMI and WC, which represent overall obesity and central obesity, respectively, have both been associated with periodontal diseases (Ganesan et al, 2021). Some have suggested that WC is a preferable indicator, because central obesity was found to be more strongly associated with periodontal disease than overall obesity (Kim et al, 2011; Tegelberg et al, 2021). The present MR study found a similar effect size between BMI and WC on the risk of periodontitis/loose teeth.…”