Today, Thursday, January 24, 2019

The Link Between Obesity and Gum Disease

With obesity at epidemic levels across the United States, people are becoming more acutely aware of the sort of problems that stem from being grossly overweight.  Obesity is a well-known factor for heart disease, diabetes, and possibly even certain types of cancer.  

Relatively new evidence however, suggests that obesity might also put people at an increased risk for gum disease. 

The Case Western Study
In a study from the May 2003 issue of the Journal of Periodontology, researchers from the Case Western Reserve University found a notable association between obesity and the prevalence of gum disease.  This study in particular noted that instances were especially high among people in the 18-34 year old age demographic.  

In the study, which surveyed 13,665 people, all participants were given a periodontal examination.  Participants were also screened for body mass index and waist circumference to indicate the presence of obesity.  Research revealed that instances of gum disease among 18-34 year old obese people were 76% higher than the normal weight class individuals from this same age group.

In the middle and older age groups they found no significant association between body weight and periodontal disease.  Researchers have offered several plausible explanations as to why obesity and gum disease are more closely linked in the 18-34 year old demographic than in older age groups. 

Dietary trend analysis among the 11 to 18 year old adolescents reveal significant decreases in their intake of raw fruit and non-potato vegetables, both good sources of vitamin C.  Adolescents are also prone to decreased calcium intake and tend to consume more soft drinks and non-citrus juices.  This may be significant in that low intake of vitamin C and calcium are often associated with periodontal disease.  

Young People at Risk for Obesity and Gum Disease
According to Dr. Mohammad S. Al-Zahrani, of the Center for Health Promotion Research at Case Western, “Periodontists have known for a while that people who consume less than the recommended dietary allowance (RDA) for calcium and vitamin C have slightly higher rates of periodontal disease.” 

As young people are now drinking more soft drinks and non-citrus fruit juice than milk and other healthier beverages, this decreases their calcium and vitamin C intake, which means they make be at an increasingly high risk of contracting periodontal disease. 

As Dr. Al-Zahrani put it, “Periodontitis has long been considered an ‘older persons' disease, as more than half of people aged 55 or older have it.  We now know that widespread risk factors such as obesity may also compromise periodontal health in younger populations.”

Dr. Al-Zahrani cited other possible reasons for the link between obesity and gum disease, among them the social stigma associated with obesity in young people.  Whereas for older adults being overweight is considered more acceptable, obesity among younger adults is a potential causative for chronic stress.  Stress and people's coping mechanisms for dealing with stress have also been associated with an increased risk for periodontal disease.

The Harvard Study

A more recent study conducted by Monika Jimenez and her colleagues at the Harvard School of Public health analyzed data from 37,000 men who participated in the Health Professionals Follow-up Study.  The participants who were free of gum disease at baseline were followed up on for 16 years between 1986 and 2002.  

Information was gathered on the men's height, weight and instances of self-reported gum disease diagnoses.   Waist and hip measurements were also recorded.  

According to Dr. Jimenez, “Obesity was associated with a 29 percent increased risk of periodontal disease over the course of the study,” when compared to those of normal weight.  She based her conclusion on the standard definition of obesity as a body-mass index of 30 or higher.

Dr. Jimenez's findings also point to a viable link between waist circumference and gum disease.  Men with 40 or more inch waists, in addition to being at higher risk for heart disease, were also considered to have a 19 percent higher risk of getting gum disease than those whose waistlines were under 40 inches.  

In a study by another of Dr. Jimenez's groups at the University of Puerto Rico, it was discovered that an increased waist-hip ratio (WHR) lead to a greater risk for moderate gum disease in men and women aged 70 and over.  

What the Experts Had to Say
David Cochran, President of the American Academy of Periodontology and Chairman of the Department of Periodontics at the University of Texas Health Science Center at San Antonio, has also offered his opinions on the relation between obesity and gum disease.

“It's been known that diabetics' gum disease is worse,” he said.  Further adding that, “Periodontal inflammation and inflammation throughout the body are very much associated with one another.” Stating the inflammation is probably the common denominator, Cochran also noted the apparent relation between heart disease and gum disease as well as gum disease and the risk for certain types of cancer.

Citing the findings at Case Western, Gordon Douglass, D.D.S. and president of the American Academy of Periodontology also added, “This is one more finding that shows healthy nutrition and adequate physical activity are necessary for overall health, and may also help to improve periodontal health by reducing the rate of progression of periodontal disease.”

In an altogether separate study, researchers from the University at Buffalo reached a similar conclusion. That study, which was published in a 2006 issue of the Journal of Periodontology, called obesity a significant predictor of periodontal disease, independent of age, race, gender, ethnicity and smoking.  Dr. Kenneth Krebs of the American Association of Periodontology has gone even one step further by noting that the presence of periodontal infection combined with obesity may contribute to type 2 diabetes and its complications, such as coronary heart disease. 

Although further studies are needed, this research reveals that obesity and gum disease may go hand in hand.  Clearly, a healthy lifestyle and good oral hygiene combined with regular dental care are the best preventatives against this disease.

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