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Obesity: A Risk Factor for Gum Disease or Not?

Posted Mar 06 2013 9:31am

No sooner had we started to write about this –

From Dr. Bicuspid, February 6

From Dr. Bicuspid, February 6

when an email alert popped up with news of this –

From Dr. Bicuspid, February 15

From Dr. Bicuspid, February 15

Is it any wonder why people think health news can sometimes be crazy-making?

Over the past few years, research – such as this and this – has repeatedly suggested a link between obesity and gum disease. Notably, these conditions are both marked by inflammation – the immune system responding to injury, infection or toxins.

In fact, all conditions thus far linked with gum disease – heart disease, stroke, diabetes, joint pain – are likewise inflammatory processes.

Inflammation is the common denominator – a point at the core of the first study noted above. Published in General Dentistry, the paper establishes obesity as a “risk factor” for perio problems.

“We know that being overweight can affect many aspects of a person’s health,” says Charlene Krejci, DDS, MSD, lead author of the article…. “Obese individuals’ bodies relentlessly produce cytokines, proteins with inflammatory properties. These cytokines may directly injure the gum tissues or reduce blood flow to the gum tissues, thus promoting the development of gum disease.”

Or they may not, according to findings presented at this year’s Research Day of the Dental Research Institute at the University of Toronto.

Analyzing two years of data collected through interviews and clinical exams, the research team

found that there was not a statistically significant relationship between being overweight, obese, or morbidly obese and having periodontitis. In fact, there was a slight, albeit nonstatistically significant, reduction in the odds of having periodontitis among the morbidly obese.

Of course, they also found that only 15% of their sample had periodontitis (the more severe form of gum disease in which bone loss occurs). That’s amazingly low when you consider that periodontitis is a problem shared by nearly half of American adults (47%).

The prevalence of periodontitis in the Canadian cohort would probably have been higher if the definition was based on a full-mouth examination, according to [senior study member] Dr. [Carlos] Quiñonez. The Canadian Health Measures Survey only took periodontal measurements at six sites in the mouth.

Indeed, that explains a lot. Periodontitis is usually defined by the presence of two or more sites with at least 3 mm of clinical attachment loss, and two or more sites with at least 4 mm pockets. That’s a maximum of just four sites among as many as 32 teeth. Only measuring 6 sites leaves plenty of room for error.

Another factor noted by Dr. Quiñonez: “This was a sample of relatively healthy, young to middle-aged adults” with good oral health habits. And that certainly does eliminate a lot of risk factors, including age, poor hygiene and tobacco use.

Previous studies have “found at least a 35% increased risk for periodontitis among obese individuals.”

For the time being, at least, the first headline is the one you should pay attention to.


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