Factors of Obesity Affecting Periodontitis

Review Article

Austin J Dent. 2023; 10(1): 1170.

Factors of Obesity Affecting Periodontitis

Yan Y1, Wang W1, Yu F1 and Su S1,2*

1School of Stomatology, Lanzhou University, Lanzhou 730000, China

2Healthy Examination & Management Center, First Hospital of Lanzhou University, Lanzhou 730000, China

*Corresponding author: Su SSchool of Stomatology, Lanzhou University & Healthy Examination & Management Center, First Hospital of Lanzhou University, Lanzhou 730000, China

Received: January 31, 2023; Accepted: March 08, 2023; Published: March 15, 2023


Obesity is a systemic chronic low-grade inflammatory reaction, a chronic oxidation process that can damage the body’s physiological functions and lead to various diseases. Periodontitis is the second largest disease affecting oral health and is also harmful to general health. Research has found that obesity provides an inflammatory environment for periodontitis and plays an important role in the occurrence and development of periodontitis. This article mainly reviewed several factors that obesity affects periodontitis, including adipose factors, inflammatory reaction, immune reaction, oxidative stress, insulin resistance, and the increase of periodontal pathogens caused by obesity. Therefore, in treating obesity, we also need to pay attention to periodontal health.

Keywords: Obesity; Periodontitis; Factors


Obesity is a chronic disease which has become a public security issue. When the body takes in more calories than it consumes, the excess calories are stored in the body as fat, and it becomes obese when it reaches a certain value. Obesity is related to many factors, such as genetic, neuropsychiatric, endocrine, environmental, and so on. Body Mass Index (BMI) is commonly used to evaluate obesity in clinical practice, and obesity is defined when BMI exceeds 28 kg/m2. Overweight and obesity have continued to rise worldwide in recent years. According to the World Health Organization, by 2015, approximately 2.3 billion adults will be overweight, and more than 700 million will be obese [1]. Overweight and obesity among children are also on the rise in China. In 2014, compared with 1985, the overweight rate of children over seven years old increased by 10%, and the obesity rate increased by 7%. It also shows that if effective intervention measures are not taken, by 2030, the detection rate of overweight and obesity in school-age children over seven years old will reach 28.0%, and the number will increase to 49.48 million [2]. However, according to statistics, there has been no significant social effect in curbing the rate of overweight in the past 15 years [3]. It shows that many key risk factors can be changed by individual or group efforts and concerted national and even global action.

Globally, obesity has become a public safety problem. The increasing prevalence of obesity poses a considerable threat to public health, leading to complications such as type 2 diabetes mellitus, cardiovascular disease, and metabolic disorder syndrome [4-7]. In 2015, statistical data showed that its complications caused 4 million deaths worldwide in the past decade [8]. Therefore, the prevention and treatment of obesity are crucial. In recent years, scholars have found that obesity is associated with periodontitis and proposed that inflammatory cell markers, adipocytokines, oxidative stress, insulin resistance, and microbiota can be used to predict obesity in the early stage [9,10], which provides new research ideas for the early prevention and control of obesity. At the same time, researchers have found that inflammatory cell markers, adipocytokines, oxidative stress, insulin resistance, and microbiota in obese people also play important roles in developing periodontitis.


Periodontitis is a chronic inflammatory disease caused by multiple factors resulting from a complex dynamic interaction among specific bacterial pathogens, destructive host immune responses, and environmental factors (such as smoking) [11]. Its main feature is the progressive destruction of tooth-supporting tissues. It is characterized by gingival bleeding, clinical attachment loss, periodontal pocket formation, alveolar bone loss assessed by imaging, pathological tooth displacement, and loosening [12]. In general, oral examination and imaging examination are necessary for clinical diagnosis.

The initiating factor of periodontitis is dental plaque, a kind of biofilm attached to the tooth surface. It has rich bacterial diversity and complex structure with a high density of bacteria, which not only helps protect the bacteria against external adverse factors but also promotes the synergistic interaction between bacteria and the formation of a quorum sensing system. Thus, they have higher virulence and environmental adaptability [13]. Existing studies have fully demonstrated that Aggregatibacter actinomycetemcomitans (A.a) and Porphyromonasgingivalis (P.g) in dental plaque play an important role in the occurrence and development of periodontitis [14,15].

Correlation between Obesity and Periodontitis

A cross-sectional study found that the prevalence of periodontitis in grade 1, 2, and 3 obesity was 79.2%, 2.8%, and 1.6%, respectively. Periodontal pocket depth was significantly correlated with the determinants of obesity, especially in grade 2 and 3 obese individuals [16], indicating that the higher the obesity grade, the higher the prevalence of periodontitis. It may be related to many important factors in obesity. Maulani et al. [17] analyzed the BMI and periodontitis related indexes of 262 subjects. They found that people with BMI greater than 25 kg/m2 were more correlated with periodontitis-related indexes and had a higher risk of periodontitis than normal-weight people. These results suggest that obesity plays a role in the pathogenesis of periodontitis. In addition, complications of obesity have also been found to be associated with the development of periodontitis. Mukherjee et al. [18] conducted a cross-sectional study on 250 subjects and found that hypertension and BMI were risk factors for periodontitis. A moderate positive correlation was found between periodontitis and obstructive sleep apnea. In obese people with Insulin Resistance (IR), the probability of periodontitis is greater but not more serious [19]. Oliveira et al. [20] found that obese patients with metabolic syndrome or diabetes had an increased risk of periimplantitis. These results suggest that complications of obesity also increase the risk of periodontitis.

Citation: Yan Y, Wang W, Yu F, Su S. Factors of Obesity Affecting Periodontitis. Austin J Dent. 2023; 10(1): 1170.