Obesity, Periodontal Disease and Tooth Loss in a Population Study

Objective: There is much debate about inter-relationships between periodontitis and systemic diseases, viz. cardiovascular diseases, diabetes, and others. Common risk factors of all of them are known fueling this discussion. Central obesity seems to increase the severity of all of these multifactorial diseases and, thus, it was the aim of this study to prove the impact of obesity on periodontal measures in a population-based cross-sectional study without selection bias.

Methods: In 4,290 randomly selected subjects aged 20-80 from the normal population (Study of Health In Pomeranis, SHIP), we determined anthropometric measures including waist and hip circumference and body mass index (BMI) and diagnostic periodontal parameters. Behavioral and environmental risk factors were assessed by interviews and questionnaires.

Results: When adjusted for age, sex, smoking, fibrinogen, HbA1c, education, last dentist's appointment the periodontal parameters were significantly related to waist-to-hip ratio: % attachment loss>3mm, p=0.008, % probing depth>4mm, p<0.001, probing depth mean in mm, p<0.001, gingival plaque, p<0.001. Likewise, the LDL/HDL ratio is positively correlated with periodontal measures. Comparing the age- and sex-stratified tertiles of number of teeth, the BMI-related odds ratio was 1.5 (95% C.I. 1.2-1.8) for subjects with BMI>30 as compared to those with BMI<=25.

Conclusions: In this cross-sectional poulation study, obesity is significantly related to all periodontal parameters measured, including tooth loss. It is hypothesized, that inflammatory signals from visceral fat masses predispose to more severe periodontitis as well as to systemic diseases with inflammatory background.

This work is part of the Community Medicine Research net (CMR) of the University of Greifswald, Germany, which was funded by the Federal Ministry of Education and Research, Germany (grant no. ZZ9603).