Obesity as a risk factor for periodontitis - does it really matter?

Data Sources: MEDLINE, Scopus, Web of Science Core Collection and Cochrane Library were systematically searched for studies published between January 2000 and June 2022.

Study Selection: Case-control, cross-sectional and cohort studies investigating the relationship between obesity (determined using BMI) and periodontitis (diagnosed based on clinical attachment loss and probing pocket depth) in adults between 18 and 70 years. Animal studies and systematic reviews were also included. Exclusion criteria included non-English studies and studies involving participants with poor oral health, pregnancy, menopause, and systemic disease.

Data Extraction And Synthesis: Data extracted included study demographic data, study design, age range of participants, sample size, study population, obesity criteria, definition of periodontitis used, tooth loss and bleeding on probing. Two reviewers collected the data and disputes were settled by consulting a third reviewer. Risk of bias was measured using the Newcastle-Ottawa Quality Assessment Scale. Qualitative analysis was performed whilst meta-analysis was not performed.

Results: From 1982 studies initially identified, 15 studies were included in the review. Human studies generally showed a positive association between obesity and periodontitis; however, animal studies showed contrasting results. Risk of bias was low in 7 studies, moderate in 5 studies and high in 3 studies.

Conclusions: Obesity is positively associated with periodontitis; however, a causal relationship cannot be established.