Cent Eur J Public Health 2013, 21(4):196-201 | DOI: 10.21101/cejph.a3829

Association of Obesity with Periodontitis, Tooth Loss and Oral Hygiene in Non-smoking Adults

Jelena Prpić1, Davor Kuiš1, Irena Glažar1, Sonja Pezelj Ribarić1
Department of Oral Medicine and Periodontology, School of Dentistry, Medical Faculty, University of Rijeka, Rijeka, Croatia

Background: Periodontitis was found to be significantly related to obesity as well as the number of missing teeth and oral hygiene. However, the studies addressing these relationships often included smokers and diabetics, and none was performed in Eastern European patients. The aim of this cross-sectional study was to investigate associations between obesity and periodontitis, oral hygiene, and tooth loss in a sample of non-smoking Croatian subjects aged 31-75 years.

Methods: A total of 320 patients were recruited by convenient sampling at the Dental Clinic, Clinical Hospital Centre in Rijeka, Croatia. Periodontal examination and data on tooth loss were completed in 292 subjects and each participant completed a structured written questionnaire with questions regarding oral hygiene, education, height, and weight. Periodontitis was categorized as early, moderate and advanced. In multiple regression analysis, periodontitis was used as predictor variable, and BMI, oral hygiene, tooth loss, and education level were used as dependent variables.

Results: Use of interdental brushes/flossing and number of missing teeth correlated significantly with BMI, but the same could not be proven for periodontitis and frequency of tooth brushing. However, logistic regression proved that the subset of obese, poorly educated women aged 36-55 years were 5-6 times more likely to develop severe forms of periodontal disease.

Conclusions: Obesity was associated with tooth loss, oral hygiene, and education level in the investigated group. BMI could not be correlated with severity of periodontal disease, except in poorly educated women aged 36-55 years.

Keywords: Body Mass Index - BMI, dental devices, home care, obesity, periodontitis, tooth loss

Received: August 21, 2012; Revised: October 23, 2013; Accepted: October 23, 2013; Published: December 1, 2013  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Prpić J, Kuiš D, Glažar I, Pezelj Ribarić S. Association of Obesity with Periodontitis, Tooth Loss and Oral Hygiene in Non-smoking Adults. Cent Eur J Public Health. 2013;21(4):196-201. doi: 10.21101/cejph.a3829. PubMed PMID: 24592723.
Download citation

References

  1. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.
  2. Kopelman PG. Obesity as a medical problem. Nature. 2000 Apr 6;404(6778):635-43. Go to original source... Go to PubMed...
  3. Perlstein MI, Bissada NF. Influence of obesity and hypertension on the severity of periodontitis in rats. Oral Surg Oral Med Oral Pathol. 1977 May;43(5):707-19. Go to original source...
  4. Saito T, Shimazaki Y, Sakamoto M. Obesity and periodontitis. N Engl J Med. 1998 Aug 13;339(7):482-3. Go to original source... Go to PubMed...
  5. Saito T, Shimazaki Y, Koga T, Tsuzuki M, Ohshima A. Relationship between upper body obesity and periodontitis. J Dent Res. 2001 Jul;80(7):1631-6. Go to original source... Go to PubMed...
  6. Wood N, Johnson RB, Streckfus CF. Comparison of body composition and periodontal disease using nutritional assessment techniques: Third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol. 2003 Apr;30(4):321-7. Go to original source... Go to PubMed...
  7. Nishida N, Tanaka M, Hayashi N, Nagata H, Takeshita T, Nakayama K, et al. Determination of smoking and obesity as periodontitis risks using the classification and regression tree method. J Periodontol. 2005 Jun;76(6):923-8. Go to original source... Go to PubMed...
  8. Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, et al. Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study. J Periodontal Res. 2005 Aug;40(4):346-53. Go to original source... Go to PubMed...
  9. Dalla Vecchia CF, Susin C, Rösing CK, Oppermann RV, Albandar JM. Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol. 2005 Oct;76(10):1721-8. Go to original source... Go to PubMed...
  10. Linden G, Patterson C, Evans A, Kee F. Obesity and periodontitis in 60-70-year-old men. J Clin Periodontol. 2007 Jun;34(6):461-6. Go to original source... Go to PubMed...
  11. Han DH, Lim SY, Sun BC, Paek DM, Kim HD. Visceral fat area-defined obesity and periodontitis among Koreans. J Clin Periodontol. 2010 Feb;37(2):172-9. Go to original source... Go to PubMed...
  12. Socransky SS, Haffajee AD. Periodontal microbial ecology. Periodontol 2000. 2005;38:135-87. Go to original source... Go to PubMed...
  13. Al-Zahrani MS, Bissada NF, Borawskit EA. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol. 2003 May;74(5):610-5. Go to original source... Go to PubMed...
  14. Alabdulkarim M, Bissada N,Al-Zahrani M, FicaraA, Siegel B.Alveolar bone loss in obese subjects. J Int Acad Periodontol. 2005 Apr;7(2):34-8. Go to PubMed...
  15. Saito T, Shimazaki Y. Metabolic disorders related to obesity and periodontal disease. Periodontol 2000. 2007;43:254-66. Go to original source... Go to PubMed...
  16. Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol. 2008 Aug;79(8 Suppl):1560-8. Go to original source... Go to PubMed...
  17. Tintera J, Harantová P, Suchánek P, Dvoráková A, Adamová M, Hájek M, et al. Quantification of intra-abdominal fat during controlled weight reduction: assessment using the water-suppressed breath-hold MRI technique. Physiol Res. 2004;53(2):229-34.
  18. Doll HA, Petersen SE, Stewart-Brown SL. Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res. 2000 Mar;8(2):160-70. Go to original source... Go to PubMed...
  19. Hassan MK, JoshiAV, Madhavan SS,Amonkar MM. Obesity and healthrelated quality of life: a cross-sectional analysis of the US population. Int J Obes Relat Metab Disord. 2003 Oct;27(10):1227-32. Go to original source... Go to PubMed...
  20. Hujoel PP, Cunha-Cruz J, Kressin NR. Spurious associations in oral epidemiological research: the case of dental flossing and obesity. J Clin Periodontol. 2006 Aug;33(8):520-3. Go to original source... Go to PubMed...
  21. Willershausen B, Haas G, Krummenauer F, Hohenfellner K. Relationship between high weight and caries frequency in German elementary school children. Eur J Med Res. 2004 Aug 31;9(8):400-4.
  22. Cinar AB, Murtomaa H. Interrelation between obesity, oral health and life-style factors among Turkish school children. Clin Oral Investig. 2011 Apr;15(2):177-84. Go to original source... Go to PubMed...
  23. Franchini R, Petri A, Migliario M, Rimondini L. Poor oral hygiene and gingivitis are associated with obesity and overweight status in paediatric subjects. J Clin Periodontol. 2011 Nov;38(11):1021-8. Go to original source... Go to PubMed...
  24. Milanović SM, Uhernik AI, Fister K, Mihel S, Kovac A, Ivanković D. Five-year cumulative incidence of obesity in adults in Croatia: the CroHort study. Coll Antropol. 2012 Jan;36 Suppl 1:71-6. Go to original source... Go to PubMed...
  25. Aguilera A, Leykin Y, Adler N, Muñoz RF. Assessing the impact of relative social position and absolute community resources on depression and obesity among smokers. Am J Community Psychol. 2012 Sep;50(12):211-6. Go to original source... Go to PubMed...
  26. Ahmed F, Waslien C, Al-Sumaie MA, Prakash P. Secular trends and risk factors of overweight and obesity among Kuwaiti adults: National Nutrition Surveillance System data from 1998 to 2009. Public Health Nutr. 2012 Nov;15(11):2124-30. Go to original source... Go to PubMed...
  27. Wronka I, Suliga E, Pawlińska-Chmara R. Socioeconomic determinants of underweight and overweight in female Polish students in 2009.Anthropol Anz. 2012;69(1):85-96. Go to original source...
  28. Nédó E, Paulik E. Association of smoking, physical activity, and dietary habits with socioeconomic variables: a cross-sectional study in adults on both sides of the Hungarian-Romanian border. BMC Public Health. 2012 Jan 20;12:60. Go to original source... Go to PubMed...
  29. Ritchie CS, Joshipura K, Hung HC, Douglass CW. Nutrition as a mediator in the relation between oral and systemic disease: associations between specific measures of adult oral health and nutrition outcomes. Crit Rev Oral Biol Med. 2002;13(3):291-300. Go to original source... Go to PubMed...
  30. Sheiham A, Steele JG, Marcenes W, Finch S, Walls AWG. The impact of oral health on stated ability to eat certain foods; findings from the National Diet and Nutrition Survey of Older People in Great Britain. Gerodontology. 1999 Jul;16(1):11-20. Go to original source... Go to PubMed...
  31. Hilgert JB, Hugo FN, Sousa MdLRd, Bozzetti MC. Oral status and its association with obesity in Southern Brazilian older people. Gerodontology. 2009 Mar;26(1):46-52. Go to original source... Go to PubMed...
  32. Touger-Decker R, Mobley CC; American Dietetic Association. Position of theAmerican DieteticAssociation: oral health and nutrition. JAm Diet Assoc. 2007 Aug;107(8):1418-28. Go to original source... Go to PubMed...
  33. Salekzamani Y, Shirmohammadi A, Rahbar M, Shakouri SK, Nayebi F. Association between Human Body Composition and Periodontal Disease. ISRN Dent. 2011;2011:863847. Go to original source... Go to PubMed...
  34. Mathur LK, Manohar B, Shankarapillai R, Pandya D. Obesity and periodontitis: a clinical study. J Indian Soc Periodontol. 2011 Jul;15(3):240-4. Go to original source... Go to PubMed...
  35. Kongstad J, Hvidtfeldt UA, Grønbaek M, Stoltze K, Holmstrup P. The relationship between body mass index and periodontitis in the Copenhagen City Heart Study. J Periodontol. 2009 Aug;80(8):1246-53. Go to original source... Go to PubMed...
  36. Ivić-Kardum M. Prevalence of progressive periodontal disease in the population of Zagreb. Acta Stomatol Croat. 2000;34(2):157-61.
  37. Isomoto H, Ueno H, Nishi Y, Wen CY, Nakazato M, Kohno S. Impact of Helicobacter pylori infection on ghrelin and various neuroendocrine hormones in plasma. World J Gastroenterol. 2005 Mar 21;11(11):1644-8. Go to original source...
  38. Ritchie CS, Joshipura K, Hung HC, Douglass CW. Nutrition as a mediator in the relation between oral and systemic disease: associations between specific measures of adult oral health and nutrition outcomes. Crit Rev Oral Biol Med. 2002;13(3):291-300. Go to original source... Go to PubMed...
  39. Ostberg AL, Nyholm M, Gullberg B, Råstam L, Lindblad U. Tooth loss and obesity in a defined Swedish population. Scand J Public Health. 2009 Jun;37(4):427-33. Go to original source... Go to PubMed...
  40. Mojon P, Budtz-Jørgensen E, Rapin CH. Relationship between oral health and nutrition in very old people. Age Ageing. 1999 Sep;28(5):463-8. Go to original source...
  41. Bray GA. Obesity is a chronic, relapsing neurochemical disease. Int J Obes Relat Metab Disord. 2004 Jan;28(1):34-8. Go to original source... Go to PubMed...
  42. Falagas ME, Kompoti M. Obesity and infection. Lancet Infect Dis. 2006 Jul;6(7):438-46. Go to original source... Go to PubMed...
  43. Boesing F, Patiño JSR, da Silva VRG, Moreira EAM. The interface between obesity and periodontitis with emphasis on oxidative stress and inflammatory response. Obes Rev. 2009 May;10(3):290-7. Go to original source... Go to PubMed...
  44. Lundin M,Yucel-LindbergT, Dahllöf G, Marcus C, ModéerT. Correlation between TNFalpha in gingival crevicular fluid and body mass index in obese subjects. Acta Odontol Scand. 2004 Oct;62(5):273-7. Go to original source... Go to PubMed...