The Link Between Obesity and Gum Disease

Research shows that people who are overweight are more likely to have periodontal disease, and inflammation may be to blame.

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There are many reasons to maintain a healthy weight for your body type. Now here's one more: Being overweight may put you at risk for periodontal disease, a constellation of serious gum infections that can lead to bone loss and other illnesses if not treated.

A 2020 review of evidence in the Journal of Family Medicine and Primary Care suggests that gum disease, typically caused by inflammatory disorders, is prevalent in obese populations and demonstrates "an increasing trend and a correlation with numerous comorbidities." The review follows a decade of research linking periodontal disease with excessive body weight.

Also, a 2017 study published in the journal Oral Diseases, found that overweight individuals with body mass indexes (BMI) of 23 or higher experienced worse oral health than "normal weight" participants and were 4.2 times more likely to have severe gum disease. Additionally, white blood cells and C-reactive protein, markers of inflammation in the blood, were also higher in overweight participants. Obese individuals, with BMIs of 25 or higher, were 5.9 times more likely to experience periodontal disease than average-weight participants. One hundred and sixty people were included in the research.

Understanding BMI Ranges

It is important to note that in the United States, the Centers for Disease Control and Prevention (CDC) defines a healthy BMI range as 18.5 to 25. BMIs between 25 and 30 are considered overweight, and a BMI of 30 or higher is deemed obese. BMIs of 30 and above are then grouped into different obesity severity classifications. If you are curious about your BMI, the CDC has an adult BMI calculator for individuals over 20 years old.

If your BMI falls within one of the categories that is considered unhealthy, it is important to understand that BMI is only a screening tool. Your healthcare provider can help you assess your overall quality of health and perform any additional assessments.

Obesity and Inflammation

It's commonly understood among healthcare providers that obesity contributes to inflammation in the body, which has long been associated with gum disease, said Yiping Han, PhD, professor of microbial sciences in dental medicine at Columbia University.

"We know inflammation is an underlying cause of many diseases—periodontal disease but also cardiovascular disease and many cancers," said Dr. Han. "Obesity is a risk factor for many of these ailments, so there's a natural connection there."

Evidence that extra weight causes inflammation has grown over the years. "Obesity-induced adipose tissue expansion provides a plethora of intrinsic signals...capable of initiating the inflammatory response," according to a 2020 review article published in Frontiers of Physiology.

Periodontal Disease and Inflammation

Obesity-related inflammation has been shown to deregulate the body's immune system, according to Salvador Nares, DDS, director of periodontics research at the University of Illinois at Chicago College of Dentistry.

"Periodontal disease is an infectious, immune-mediated disease," said Dr. Nares. "That means that obese people are going to be more susceptible to the bacteria that cause gum disease and the bacteria that cause cavities than other folks."

Why Periodontal Disease Is Dangerous

Periodontal disease has also been linked to many health conditions, including an increased risk of stroke and heart disease, so it's important to maintain good oral hygiene and a healthy weight. The interplay between obesity and gum disease "may enhance the risk of cardiovascular disease in overweight or obese individuals," according to the study in Oral Diseases.

Periodontal disease can also lead to tooth loss and may even be linked to rheumatoid arthritis. So avoiding risk factors such as smoking, poor nutrition, diabetes, and, yes, overeating, is always a good idea.

"The take-home message here is that the body is connected," said Dr. Nares, "and the mouth, in many ways, is a window to a person's systemic health."

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