Obesity and periodontal disease in diabetic pregnant women

Abstract

ABSTRACT:This cross-sectional study investigated the impact of pregestational overweight and obesity on periodontal status of patients with gestational diabetes mellitus (GDM). Sixty pregnant women with gestational diabetes mellitus (GDM) were recruited for the study. According to the pregestational body mass index (BMI), patients were classified into 3 groups: normal, overweight or obese. The periodontal assessment parameters were the presence of gingival bleeding (GB) and bleeding on probing (BOP) per tooth. Clinical attachment loss (CAL) was assessed per tooth and classified according to following values: 1) absence of attachment loss; 2) between 1 and 2 mm, 3) between 3 and 5 mm; and 4) CAL ≥ 6 mm. The means of individual percentage of teeth with GB and BOP and the means of the individual classified values of CAL were compared through ANOVA. Differences between the groups were established through post hoc Bonferroni test for multiple comparisons (p < 0.05). The analysis revealed significant differences between the normal group and the obese group considering GB (52.76% ± 27.99% and 78.85% ± 27.44%, respectively) and CAL (2.21 ± 0.41 and 2.61 ± 0.54, respectively). Although an increase was found in BOP as the BMI increased (ranging from 55.65% to 75.31%), no statistically significant differences were found among the groups. Patients with GDM and pregestational obesity had significantly more gingivitis and periodontal attachment loss that those with normal pregestational BMI. Periodontal treatment should be considered in the establishment of future recommendations for metabolic control for this special group of patients. DESCRIPTORS: Diabetes, gestational; Obesity; Gingivitis; Periodontitis; Oral manifestations. RESUMO:O objetivo do presente estudo foi examinar o efeito da massa corporal prévia à gestação (IMC -índice de massa corpórea) sobre o periodonto de pacientes com diabete mellitus gestacional (DMG). A amostra constituiu-se de 60 gestantes classificadas em 3 grupos segundo o IMC: normal, sobrepeso ou obeso. Os parâmetros de avaliação periodontal foram sangramento gengival (SG), sangramento à sondagem (SS) e perda de inserção clínica periodontal (PI) categorizada de acordo com os seguintes valores: 1) correspondente à ausência de perda de inserção; 2) PI entre 1 e 2 mm, 3) PI entre 3 e 5 mm; e 4) PI ≥ 6 mm. Médias das porcentagens dos dentes com SG e SS e as médias dos valores categorizados, por dente, da perda de inserção foram comparadas por meio do teste ANOVA e as diferenças entre os grupos foram estabelecidas por meio do teste post hoc de Bonferroni para comparações múltiplas (p < 0,05). Diferenças estatisticamente significantes foram identificadas entre o grupo normal e obeso com relação às médias percentuais da presença de SG (52,76 ± 27,99% e 78,85 ± 27,44%, respectivamente) e às médias da categorização da PI (2,21 ± 0,41 mm e 2,61 ± 0,54 mm, respectivamente). Embora tenha se observado aumento no percentual médio de SS à medida do incremento do IMC, não foram observadas diferenças estatisticament...

Prepregnancy Obesity and Periodontitis Among Pregnant Females With and Without Gestational Diabetes Mellitus

“…Obesity (defined as BMI >29 kg/m 2 ) was not associated with periodontal disease in this study 45 . All three of these studies were conducted in Brazil 43‐45 . The design of all these studies was cross‐sectional; thus, it is difficult to determine the temporal relationship between obesity and periodontal disease 43‐45 .…”

“…However, they did not mention any adjustment for GDM 43 . Chapper et al 44 recruited 60 non‐smoking pregnant females with GDM in a cross‐sectional study in Brazil, and they reported that females with pregestational obesity had significantly more gingivitis and periodontal attachment loss compared with those with normal BMI. However, the authors did not explicitly define periodontal disease 44 .…”

“…Chapper et al 44 recruited 60 non‐smoking pregnant females with GDM in a cross‐sectional study in Brazil, and they reported that females with pregestational obesity had significantly more gingivitis and periodontal attachment loss compared with those with normal BMI. However, the authors did not explicitly define periodontal disease 44 . In another cross‐sectional study conducted among 334 pregnant females, Vogt et al 45 defined periodontal disease as four or more teeth with at least one site with 4 mm of PD and CAL at the same site, with bleeding on probing.…”

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

“…Some previous studies have reported a positive association between excessive weight and periodontitis during pregnancy. Nonetheless, these studies used different methodologies for the classification of periodontitis and nutritional status.…”

Association between Pre-pregnant Overweight and Obesity and Periodontal Disease during Pregnancy: A Cross Sectional Study

“…[21] Women with pre-gestational overweight/obesity had significantly more periodontal attachment loss & gingivitis compared with those with normal ƁΜӀ. [88] A cross-sectional study applied to evaluate factors associated with periodontitis, they found that the odds of having periodontitis in pregnant women who were overweight/obese before pregnancy was 2.22 times the odds in pregnant women with normal weight. [89] The risk of Periodontitis increases by l6% per increase of 1 kg/m 2 in ƁΜӀ.…”