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Association between obesity and periodontitis

Vasilena Kuzmanova, Simeon Todorov, Atanas Kuzmanov, Stefka Valcheva-Kuzmanova


Introduction: Obesity is an excessive fat accumulation that presents a risk to health. Periodontitis is a chronic inflammation affecting the structures supporting the teeth. Obesity and periodontitis are among the most common chronic disorders worldwide. The aim of this study is to conduct a litera­ture review on the association between obesity and periodontitis.

Materials and Methods: Scientific articles were sought in PubMed and Google Scholar using the key­words: obesity, periodontitis, experimental studies, clinical studies. The selected articles were 64, in­cluding 2 systematic reviews. The selection criteria were experimental and human studies, investigat­ing whether or not obesity is a risk factor for periodontitis.

Results: Several decades ago, obesity was demonstrated to aggravate periodontal disease in rats. The relationship between obesity and periodontitis has been investigated in hundreds of clinical studies. According to the systematic reviews, the risk of periodontitis was associated with obesity in 81% and 93% of studies in patients below 15 and over 18 years of age, respectively. The exact mechanisms un­derlying this relationship are not fully understood. In obesity, there is an increased infiltration of macrophages in the adipose tissue, resulting in a chronic systemic inflammation manifested by el­evated pro-inflammatory cytokines like interleukins (IL-1 and IL-6) and tumor necrosis factor-α. The adverse effects of obesity on the periodontium may also be mediated through the increased cir­culation of reactive oxygen species which in turn cause gingival oxidative damage and progression of periodontitis. Intervention studies have shown that the response to non-surgical periodontal treat­ment is better among lean than obese patients. In order to have a better control over periodontal in­flammation, dentists should advise their obese periodontal patients for weight reduction interven­tions like diets, lifestyle changes and pharmacotherapy.

Conclusions: Studies demonstrate well that obesity is associated with periodontitis. However, the mechanisms underlying this relationship should be better elucidated.


obesity; periodontitis; review; experimental studies; clinical studies



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