Is there a prospective association between obesity and periodontal disease? This is the question asked by a team of investigators from the Harvard School of Public Health and the University of Puerto Rico, reporting their findings during the 87th General Session of the International Association for Dental Research, at the Miami Beach Convention Center.
The investigators evaluated the association between different measures of obesity and risk of periodontal disease. They analyzed data from 36,903 men from the Health Professionals Follow-Up Study who were free of reported periodontal disease at the start of follow-up, and we followed them for up to 16 years (1986-2002). Height was assessed at the start of follow-up, and weight and self-reported periodontal disease data were collected at baseline and on follow-up questionnaires mailed every two years. Measures of central obesity were made by waist and hip circumference through self-assessed measurements and reported in 1987 with the aid of printed instructions and a tape measure. Self-reported periodontal disease and adiposity measures had been previously validated. They evaluated the effect of body mass index (BMI kg/m2), waist circumference (WC), and waist-to-hip ratio (WHR), on first report of periodontal disease diagnosis.
The team observed significant associations between all measures of obesity and periodontal disease when accounting for age, smoking, race, dental profession, physical activity, fruit and vegetable intake, and diabetes status at baseline. Obesity (BMI > 30 kg/m¬2) at the beginning of follow-up and over follow-up was significantly associated with a 25% and 29% increased risk compared with normal weight (BMI 18.5-24.9 kg/m2), respectively. Men with WC > = 40 inches compared with < 40 inches was significantly associated with a 19% increased risk of periodontal disease, compared with men with a WC < 40 inches. WHR > = 0.95 compared with < 0.95 exhibited a significant 16% increased risk of periodontal disease. When BMI was accounted for (i.e., overall obesity), the effects of WC and WHR (i.e., central obesity) were weakened. The associations of BMI and WC were significant even among non-diabetics and among those who had never smoked.
These results provide the first evidence following a large group of people over time with clear evidence of obesity occurring prior to periodontal disease, and support an association between obesity and risk of periodontal disease. Given the high prevalence of obesity and periodontal disease, this association may be of substantial public health importance.
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