J Korean Acad Oral Health.  2021 Mar;45(1):38-43. 10.11149/jkaoh.2021.45.1.38.

Association obesity and periodontal disease - Using the Korean National Health and Nutrition Examination Survey (KNHANES) 2016-2018

• Kim YS
• Kim EK

• KMID: 2514459
• DOI: http://doi.org/10.11149/jkaoh.2021.45.1.38

Abstract

Objectives
This study aimed to confirm the correlation between BMI and the prevalence of periodontal disease in adults, using data from the National Health and Nutrition Survey.
Methods
The data included general characteristics and oral examination results of individuals surveyed in the 7th National Health and Nutrition Survey (2016-2018). Among the variables examined, age, gender, education, income, obesity, hypertension, diabetes, high cholesterol, smoking/drinking, oral examination, and brushing habits were considered as the general characteristics of the study participants. Individuals with more than 4 mm depth of the periodontal pocket were defined as having periodontal disease. BMI was classified into underweight (BMI<18.5 kg/m² ) and normal (18.5 kg/m² Results
The prevalence of periodontal disease was higher among men, those who were older, came from a lower socioeconomic background, were obese, and had hypertension, diabetes, and hypercholesterolemia (P<0.0001). The prevalence of periodontal disease was 1.26 times (95% CI: 1.12-1.40) higher among the obese compared to individuals with a normal BMI, with the incidence being 1.28 times (95% CI: 1.03-1.43) and 1.21 times (95% CI: 1.10-1.49) higher in women and men, respectively. Additionally, the prevalence of periodontal disease was 1.35 times (95% CI: 1.14-1.59) higher among those who were obese than those with normal BMI in individuals above 60 years.
Conclusions
Even among the obese, the incidence of periodontal disease differs according to gender and age. Therefore, it is imperative to implement an appropriate oral care program taking the aforementioned characteristics into account. .

Keyword

BMI; KNHANES; Obesity; Periodontitis

Reference

References

1. Dahiya P, Kamal R, Gupta R. 2012; Obesity, periodontal and general health: Relationship and management. Indian J Endocrinol Metab. 16:88–93. DOI: 10.4103/2230-8210.91200. PMID: 22276257. PMCID: PMC3263203.

2. Pischon N, Heng N, Bernimoulin JP, Kleber BM, Willich SN, Pischon T. 2007; Obesity, inflammation, and periodontal disease. J Dent Res. 86:400–409. DOI: 10.1177/154405910708600503. PMID: 17452558.

3. Lumeng CN, Saltiel AR. 2011; Inflammatory links between obesity and metabolic disease. J Clin Invest. 121:2111–2117. DOI: 10.1172/JCI57132. PMID: 21633179. PMCID: PMC3104776.

4. World Health Organization. Obesity and overweight [Internet]. World Health Organization;Available from: https://www.afro.who.int/health-topics/obesity. cited 2020 Dec 29.

5. Statistics Korea. Obesity prevalence in Korea [Internet]. Korea Disease Control and Prevention Agency;Available from: http://www.index.go.kr/potal/main/PotalMain.do. cited 2020 Dec 29.

6. Perlstein MI, Bissada NF. 1977; Influence of obesity and hypertension on the severity of periodontitis in rats. Oral Surg Oral Med Oral Pathol. 43:707–719. DOI: 10.1016/0030-4220(77)90055-X. PMID: 266151.

7. Saito T, Shimazaki Y, Sakamoto M. 1998; Obesity and periodontitis. N Engl J Med. 339:482–483. DOI: 10.1056/NEJM199808133390717. PMID: 9705695.

8. Khosravi R, Ka K, Huang T, Khalili S, Nguyen BH, Nicolau B, et al. 2013; Tumor necrosis factor- a and interleukin-6: potential interorgan inflammatory mediators contributing to destructive periodontal disease in obesity or metabolic syndrome. Mediators Inflamm. 2013:728987. DOI: 10.1155/2013/728987. PMID: 24068858. PMCID: PMC3771422.

9. Martinez-Herrera M, Silvestre-Rangil J, Silvestre FJ. 2017; Association between obesity and periodontal disease. A systematic review of epidemiological studies and controlled clinical trials. Med Oral Patol Oral Cir Bucal. 22:e708–e715. DOI: 10.4317/medoral.21786. PMID: 29053651. PMCID: PMC5813989.

10. Shiau HJ, Reynolds MA. 2010; Sex differences in destructive periodontal disease: a systematic review. J Periodontol. 81:1379–1389. DOI: 10.1902/jop.2010.100044. PMID: 20450376.

11. Huttner EA, Machado DC, de Oliveira RB, Antunes AG, Hebling E. 2009; Effects of human aging on periodontal tissues. Spec Care Dentist. 29:149–155. DOI: 10.1111/j.1754-4505.2009.00082.x. PMID: 19573041.

12. Borrell LN, Beck JD, Heiss G. 2006; Socioeconomic disadvantage and periodontal disease: the Dental Atherosclerosis Risk in Communities study. Am J Public Health. 96:332–339. DOI: 10.2105/AJPH.2004.055277. PMID: 16380570. PMCID: PMC1470476.

13. Borrell LN, Crawford ND. 2012; Socioeconomic position indicators and periodontitis: examining the evidence. Periodontol 2000. 58:69–83. DOI: 10.1111/j.1600-0757.2011.00416.x. PMID: 22133367. PMCID: PMC3233193.

14. Kim J, Amar S. 2006; Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 94:10–21. DOI: 10.1007/s10266-006-0060-6. PMID: 16998613. PMCID: PMC2443711.

15. Meisel P, Holtfreter B, Volzke H, Kocher T. 2014; Sex Differences of Tooth Loss and Obesity on Systemic Markers of Inflammation. J Dent Res. 93:774–779. DOI: 10.1177/0022034514535604. PMID: 24828384. PMCID: PMC4293755.

16. Tanaka S, Inoue S, Isoda F, Waseda M, Ishihara M, Yamakawa T, et al. 1993; Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness. Int J Obes Relat Metab Disord. 17:631–636. PMID: 8281221.

17. Stallone DD. 1994; The influence of obesity and its treatment on the immune system. Nutr Rev. 52:37–50. PMID: 8183468.

18. Shimomura I, Funahashi T, Takahashi M, Maeda K, Kotani K, Nakamura T, et al. 1996; Enhanced expression of PAI-1 in visceral fat: possible contributor to vascular disease in obesity. Nat Med. 2:800–803. DOI: 10.1038/nm0796-800. PMID: 8673927.

19. Chaffee BW, Weston SJ. 2010; Association between chronic periodontal disease and obesity: a systematic review and meta-analysis. J Periodontol. 81:1708–1724. DOI: 10.1902/jop.2010.100321. PMID: 20722533. PMCID: PMC3187554.

20. Choi J, Joseph L, Pilote L. 2013; Obesity and C-reactive protein in various populations: a systematic review and meta-analysis. Obes Rev. 14:232–244. DOI: 10.1111/obr.12003. PMID: 23171381.

21. Khera A, Vega GL, Das SR, Ayers C, McGuire DK, Grundy SM, et al. 2009; Sex differences in the relationship between C-reactive protein and body fat. J Clin Endocrinol Metab. 94:3251–3258. DOI: 10.1210/jc.2008-2406. PMID: 19567538. PMCID: PMC2741708.

22. Linden G, Patterson C, Evans A, Kee F. 2007; Obesity and periodontitis in 60-70-year-old men. J Clin Periodontol. 34:461–466. DOI: 10.1111/j.1600-051X.2007.01075.x. PMID: 17403015.

23. Kongstad J, Hvidtfeldt UA, Grønbaek M, Stoltze K, Holmstrup P. 2009; The relationship between body mass index and periodontitis in the Copenhagen City Heart Study. J Periodontol. 80:1246–1253. DOI: 10.1902/jop.2009.080559. PMID: 19656024.

24. Borges PK, Gimeno SG, Tomita NE, Ferreira SR. 2007; [Prevalence and characteristics associated with metabolic syndrome in Japanese-Brazilians with and without periodontal disease]. Cad Saude Publica. 23:657–668. DOI: 10.1590/S0102-311X2007000300024. PMID: 17334579.

25. Li P, He L, Sha YQ, Luan QX. 2009; Relationship of metabolic syndrome to chronic periodontitis. J Periodontol. 80:541–549. DOI: 10.1902/jop.2009.080387. PMID: 19335073.

26. Al-Zahrani MS, Bissada NF, Borawskit EA. 2003; Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol. 74:610–615. DOI: 10.1902/jop.2003.74.5.610. PMID: 12816292.