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Overview

Two studies presented at the 87th General Session of the International Association for Dental Research (IADR) in Miami provide stronger indications of a possible relationship between obesity and periodontal disease. Both studies, conducted by researchers from Harvard University1 and the University of Puerto Rico,2 attracted online news coverage from Medical News Today,3 United Press International,4 and USA Today.5

The first study was an analysis of data from nearly 37,000 men participating in the Health Professionals Follow-Up Study, a long-term evaluation of nutrition and other health factors with disease incidence in male health professionals (at least half of whom are dentists). The study population did not have periodontal disease at baseline, and 3,340 of the men provided their first report of periodontal disease during the 16-year follow-up period (1986 to 2002). Overall, the scientists found that male health professionals who met the standard level of obesity [body-mass index (BMI) greater than 30 kg/m2] were at 29 percent higher risk for developing periodontitis.

In another study presented at the 2009 IADR General Session, researchers from Harvard University and the University of Puerto Rico collected measurements for height, weight, waist circumference, probing depth and attachment loss in 146 Puerto Rican men and women, aged 70 years and older, to evaluate associations between adiposity (excess fat) and periodontal disease. After analyzing the cross-sectional data, the authors determined that elderly individuals with an elevated waist-to-hip ratio (a measure of abdominal adiposity) had a significantly higher incidence of moderate periodontitis.

To date, both studies have only appeared as conference presentations, and neither has been published in a peer-reviewed research journal. Nevertheless, the preliminary findings highlight a growing body of evidence that has suggested a correlation between obesity and the incidence and progression of periodontal disease. Obesity is a significant national health issue and an independent risk for a range of chronic diseases and conditions, including hypertension, cardiovascular disease, diabetes mellitus, stroke and others. The prevalence of obesity, a primary risk factor for type 2 diabetes, has grown substantially among U.S. adults and children over the past quarter-century. Based on recent data from the CDC, over 72 million American adults are obese and at increased risk for many chronic diseases and conditions, such as atherosclerosis and type 2 diabetes.

While research evidence linking obesity and periodontal disease has expanded in recent years, additional prospective studies are still required to definitively determine the biological mechanisms and associations between the two conditions. Emerging evidence continues to suggest that obesity is associated with low-grade chronic inflammation, which can trigger production of proinflammatory cytokines that may impact the pathogenesis of periodontal disease. Scientists are currently investigating the effects of obesity, human fat cells, and central adiposity on the inflammatory pathways of periodontal disease incidence and progression.

Dentists are encouraged to promote awareness of the adverse health conditions associated with obesity, including cardiovascular disease and diabetes, and that obesity has been increasingly identified as a potential precursor to periodontal disease. Dentists can educate patients that obesity, age, and lack of physical activity are important risk factors for developing type 2 diabetes, which significantly increases a patient’s risk of developing periodontal disease. For more information, visit the U.S. Department of Agriculture’s Dietary Guidelines for Americans and the National Heart, Lung, and Blood Institute’s Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.

Footnotes

1. Jimenez M, Hu F, Li Y, Joshipura K. Is there a prospective association between obesity and periodontal disease? (Abstract #2913). 87th General Session of the International Association for Dental Research, Miami, FL, April 1–4, 2009. Abstract available at: http://iadr.confex.com/iadr/2009miami/webprogram/Paper116221.html. Accessed April 13, 2009.

2. Munoz F, Jimenez M, Joshipura K. Associations between measures of adiposity and periodontitis among older adults (Abstract #2910). 87th General Session of the International Association for Dental Research, Miami, FL, April 1–4, 2009. Abstract available at: http://iadr.confex.com/iadr/2009miami/webprogram/Paper121111.html. Accessed April 13, 2009.

3. Potential link between obesity and periodontal disease. Medical News Today, April 6, 2009. Available at: http://www.medicalnewstoday.com/articles/145163.php. Accessed April 13, 2009.

4. Obesity and periodontal disease linked. United Press International, April 6, 2009. Available at: http://www.upi.com/Health_News/2009/04/06/Obesity-and-periodontal-disease-linked/UPI-17781239073902/. Accessed April 13, 2009.

5. Doheny K. Obesity boosts gum disease risk. USA Today/HealthDay News, April 4, 2009. Available at: http://www.healthscout.com/news/68/625629/main.html. Accessed April 13, 2009.

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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.

Page Posted April 2009