Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review

Khan, Shahrukh; Barrington, G; Bettiol, SS; Barnett, Tony; Crocombe, Leonard

doi:10.1111/obr.12668

Cited by 86 publications

(102 citation statements)

References 67 publications

(192 reference statements)

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“…The aetiopathogenesis of periodontitis occurs as a result of the ecological interaction of dental plaque biofilm 5 and the host immune system response leading to metabolic changes in the bone and localisation of pro-inflammatory cytokines 6 , under the influence of lifestyle factors 7 and chronic co-morbidities 8 . The aetiopathogenesis of periodontitis occurs as a result of the ecological interaction of dental plaque biofilm 5 and the host immune system response leading to metabolic changes in the bone and localisation of pro-inflammatory cytokines 6 , under the influence of lifestyle factors 7 and chronic co-morbidities 8 .…”

Section: Introductionmentioning

confidence: 99%

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Obesity and periodontitis in Australian adults: A population-based cross-sectional study

Khan

Bettiol

Kent

et al. 2020

International Dental Journal

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Objectives Obesity and periodontitis are public health issues in Australia. This study aimed to determine the association between overweight/obesity and periodontitis in Australian adults. Materials and methods The cross‐sectional National Survey of Adult Oral Health 2004–2006 data were analysed. Body mass index was calculated, and a self‐reported questionnaire was used to measure the estimated daily intake of added sugar. The mean number of sites with probing depth (PD) ≥ 4 mm and clinical attachment loss (CAL) ≥ 4 mm and presence of periodontitis were used as outcome measures. CDC/AAP periodontitis case definition was adopted. Bivariate analyses and multiple variable regression models were constructed. Results The study sample was 4,170 participants. The proportion of people that were overweight/obese was 51.9% [95% confidence interval (CI): 48.1%, 54.1%]. Overall 21.3% (95% CI: 19.3%, 23.5%) people experienced periodontitis. The mean number of sites with PD ≥ 4 mm and CAL ≥ 4 mm were recorded as 0.7 (95% CI: 0.5, 0.9) and 2.4 (95% CI: 2.1, 2.6), respectively. Multiple variable analysis suggested that periodontal parameters [sites with PD ≥ 4 mm (0.13, 95% CI: −0.86, 0.35) and sites with CAL ≥ 4 mm (0.11, 95% CI: −0.58, 0.35) and presence of periodontitis (1.23, 95% CI: 0.96, 1.57)] were not associated with overweight/obesity when controlled for putative confounders. Conclusion A positive association was found between overweight/obesity and periodontitis (PD and CAL). However, the statistical significance disappeared in the multiple variable regression analysis, where age, sex, smoking and dental visiting behaviour were found to be key determinants of periodontitis.

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Section: Introductionmentioning

confidence: 99%

“…Obesity contributes to increased complexity of periodontal pathogens 11 and raised levels of pro-inflammatory cytokines 12 . Lifestyle changes, including higher added sugar intake, increase the susceptibility to energy imbalance often leading to weight gain 13 and other long-term health consequences including periodontitis 8 .…”

Section: Introductionmentioning

confidence: 99%

Obesity and periodontitis in Australian adults: A population-based cross-sectional study

Khan

Bettiol

Kent

et al. 2020

International Dental Journal

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“…In general, in patients with excessive weight, the adipose tissues secrete inflammatory cytokines and adipokines, such as tumor necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6), adiponectin, leptin, adipocytokines and cytoplasmic enzymes, which reduce the immune response of the host and mediate generalised systemic inflammation. Therefore, overweight or obese patients may present with greater local inflammation in the periodontium in the presence of even a small amount of bacterial plaque, resulting in periodontal disease.…”

Section: Introductionmentioning

confidence: 99%

Systemic and oral conditions of pregnant women with excessive weight assisted in a private health system

Fusco

Foratori‐Junior

Missio

et al. 2019

International Dental Journal

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Objective This observational cross‐sectional study aimed to evaluate systemic and oral conditions in pregnant women with excessive pre‐pregnancy weight (PEW) and normal pre‐pregnancy weight (PNW) who underwent follow‐up in the private healthcare system during the third trimester of pregnancy. Methods Fifty pregnant women were evaluated from August 2017 to February 2018 and divided into two groups: women with PEW (n = 25); and those with PNW (n = 25). Their weight and body mass index (BMI), periodontal disease status, stimulated salivary flow, and systemic condition were evaluated. Statistical analyses were conducted using t‐test, Mann–Whitney test, chi‐square test and binary logistic regression (P < 0.05). Results The groups did not differ in age, educational level or monthly household income (P > 0.05). The PEW group had a higher frequency of arterial hypertension (P = 0.019) and excessive weight gain during gestation (P = 0.010), sought dental services less frequently, and had increased severity of periodontitis (P < 0.0001). Both groups presented low salivary flow, with no intergroup difference. In the final binary logistic regression models, high maternal pre‐pregnancy BMI was a significant predictor of arterial hypertension and periodontitis during the third trimester of gestation; maternal excessive weight gain was also a significant predictor of periodontitis during pregnancy. Conclusion Women with PEW who underwent follow‐up in a private healthcare system had a higher prevalence of arterial hypertension and worse periodontal status during the third trimester of pregnancy as compared to women with normal weight.

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“…Initially restricted to metabolic activities, adipokines are now considered a group of heterogeneous molecules broadly involved in physiological and pathological responses . Due to their effects on immune‐inflammation, adipokines are closely related to the pathogenesis of some chronic inflammatory diseases, such as cardiovascular disease, rheumatoid arthritis and oral diseases …”

Section: Introductionmentioning

confidence: 99%

“…The concentration of adipokines in oral fluids might be indicative of obesity or other metabolic disorders and even of pathological processes of oral cavity . Therefore, the identification of adipokines at altered levels in oral fluids might be an alternative parameter to determine systemic and local alterations.…”

Section: Introductionmentioning

confidence: 99%

Association between obesity and adipokines levels in saliva and gingival crevicular fluid: A systematic review and meta‐analysis

Duffles

Hermont

Abreu

et al. 2019

J Evidence Based Medicine

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Aim This systematic review and meta‐analysis aimed to compare adipokines’ levels in gingival crevicular fluid (GCF) and saliva between individuals with obesity and individuals without obesity. Methods Computerized searches were conducted in four electronic databases (PubMed, Medline via Ovid, Web of Science, and Scopus). Manual searches and a Google Scholar search, limiting the search to the first 100 hits, were also conducted. Two calibrated authors performed the study selection, data extraction, and quality assessment of included articles. The quality of the included articles was evaluated using the University of Adelaide Tool. Results The electronic searches retrieved 929 titles/abstracts. Following the removal of duplicated references, 613 titles/abstracts were assessed. Thirty‐four articles were included. Meta‐analysis demonstrated that tumor necrosis factor‐α (TNF‐α) concentration in saliva was statistically increased in individuals with obesity compared with individuals without obesity (P < 0.05). By contrast, the meta‐analysis showed no difference in the concentrations of resistin, adiponectin, leptin, ghrelin, and interleukin 6 in saliva and of resistin, adiponectin, leptin, interleukin 6, interleukin 8, tumor necrosis factor α, and plasminogen activator inhibitor 1 in GCF between individuals with and without obesity (P > 0.05). Conclusions Individuals with obesity presented higher levels of TNF‐α in saliva than individuals without obesity. TNF‐α in saliva sampling may be a helpful marker for obesity. For the other adipokines, no difference was observed, but the limited availability and heterogeneity of data do not allow us to assertively state whether changes of adipokines in GCF and saliva are associated with obesity.

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Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review

Abstract: There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507.

Cited by 86 publications

References 67 publications

Obesity and periodontitis in Australian adults: A population-based cross-sectional study

Obesity and periodontitis in Australian adults: A population-based cross-sectional study

Systemic and oral conditions of pregnant women with excessive weight assisted in a private health system

Association between obesity and adipokines levels in saliva and gingival crevicular fluid: A systematic review and meta‐analysis

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