Definition of Obesity
Link between obesity and gum disease!!
Obesity is characterized by the abnormal or excessive deposition of fat in the adipose tissue. The definition of obesity is based on body mass index (BMI, also called Quetelet Index), which is the ratio of body weight (in kg) to body height in meter square. Obesity is defined as a body mass index (BMI) >30.0 kg/m2. Body fat distribution is assessed by the measurement of waist circumference, with 102 cm in men and 88 cm in women. Waist circumference shows a close correlation with the amount of visceral adipose tissue, and visceral adipose tissue has been shown to be metabolically more active and to secrete far greater amounts of cytokines and hormones compared with subcutaneous adipose tissue. Recent large studies have indicated that measurement of waist circumference or waist-hip ratio may be a better disease risk predictor than BMI, and there is still intensive research ongoing as to whether BMI, waist circumference or both should be used to assess disease risk. It has also been found that individuals with elevated body mass indices (BMI) produce a higher level of inflammatory proteins. The prevalence of obesity has increased substantially over the past decades in most industrialized countries.
Diet and Oral Health
Diet is very important for overall health, including dental health. Eating a low-fat, reduced sodium balanced diet of whole grains, vegetables and fruits, is recommended. Limiting the time of which sugar is in contact with the teeth is advised. Avoiding sugary beverages (sodas, fruit juices, sweetened tea) and candies (especially ones that stick to the teeth) is helpful. Eating sugary foods in between meals and before bed is also discouraged. A diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. In addition, bad eating habits, include, decrease in raw fruit, vegetable, low calcium intake.
Periodontitis( Advanced category of gum disease) is a chronic bacterial infection that affects tissues that surround and bone that support the teeth. It is the most common cause of tooth loss. Periodontal disease is classified into two stages according to the severity of the disease:
- Gingivitis: the early form of periodontal disease.
- Untreated Gingivitis: advances to the more severe form periodontitis
Warning Signs of Periodontal Disease:
- Gums that bleed easily
- Red, swollen, tender gums
- Persistent bad breath or bad taste in mouth
- Gums that have pulled away from the teeth
- Changes in the way teeth fit together when biting
- Changes in the fit of partial dentures
- Permanent teeth that are loose or separating
Treatment of Periodontal Disease
The goal of treatment for periodontal disease is to stop the progression of disease, improve the health of surrounding gums, and if indicated, to restore the supporting structures (bone, gum tissue and ligaments). Thorough cleaning, removing tartar and plaque and scraping the deep pockets free of infected tissue are the basic steps.
Gum surgery is sometimes needed for repairing deep pockets or reshaping the bone and/or surrounding tooth structures. Oral or topical antibiotics are sometimes needed. Maintenance of proper oral hygiene is essential for long-term success.
Obesity and periodontal disease
It has been suggested that obesity is second risk factor after smoking, for inflammatory periodontal tissue destruction. The prevalence of periodontal disease is higher among obese, particularly periodontitis as, obesity contributes to inflammation in the body.
What science says about fat cells?
Most research today suggests that fat cells produce many chemical signals and hormones that can increase overall inflammation in the body, decrease the effectiveness of immune system, and consequently increase your susceptibility to periodontal disease.
So, fat tissue is not merely a passive triglyceride reservoir of the body, but also produces a vast amount of inflammatory substances such as “cytokines and hormones, TNF-a, collectively called adipokines, such as leptin, resistin and adiponectin” which in turn may modulate and contribute to periodontitis. The inflammation may also decrease blood flow to the gums and cause disease progression.
Also, obesity is related to gum disease through the pathway of insulin resistance (pre-diabetes), which is a condition in which the body does not respond well to the action of insulin, of which diabetes is a documented risk factor for periodontal disease, too. Gum disease itself produces its own set of cytokines, which further increases the level of these inflammatory proteins in the body’s bloodstream, helping to set off a chain reaction of other inflammatory diseases throughout the body.
- Saito´s studies have indicated that the fat distribution pattern plays a crucial role in the association with periodontitis. Another recent study by Saito et al. concluded that obesity is associated with deep periodontal pockets, independent of glucose tolerance status.
- Genco et al. demonstrated that BMI was positively correlated with the severity of periodontal attachment loss; they found that this relationship is modulated by insulin resistance.
- Other research points to the possible eating habits of overweight people and the connections to simple sugars that our mouths convert to plaque. As plaque accumulates on teeth and gums, gingivitis (gum inflammation) will lead to periodontal disease
- A recent study showed that individuals with excess weight had double the incidence of periodontitis while individuals with severe obesity had triple the incidence.
Conversely, periodontitis, once it exists, may promote systemic inflammation and thereby increase the risk of coronary heart disease. For conditions like diabetes, the relationship is bilateral and well-documented: “Periodontal disease will affect diabetes and diabetes will worsen periodontal disease, so that could be a possibility here, too.”
Obesity is a risk factor for several chronic diseases. Since Obesity can be considered a systemic disease that predisposes to a variety of complications that affect overall health, all health professionals including dentists should require awareness regarding obesity. The first signs of a poor diet often show up in your oral health. Keys to prevention of periodontal disease are through proper oral hygiene, a balanced diet and routine dental visits. “The take-home message here is that the body is connected and the mouth, in many ways, is a window to a person’s systemic health.”