The Impact of Obesity on Periodontal Health Status in Adolescent Iraqi Students




Objetive: The aim of this study was to estimate the effect and association of obesity on the periodontal health status of middle school students. Materials and Methods: This study included 180 secondary school students aged 12- 15 years from Baghdad City in the survey. BMIfor-age (body mass index for age) was utilized to detect overweight and obesity. Furthermore, periodontal screening records (PSR) index was performed to evaluate the oral hygiene and periodontal condition of the subjects. Chisquare tests and two-way ANOVA were used for statistical analyses. Results: A highly significant association of BMI-for-age with periodontal health (codes 0, 1, 2, and 3) was observed. The association of gender and periodontal health was highly significant in code 3, significant in codes 0 and 1, and it was not significant in code 2. Additionally, the ANOVA test revealed that the effects of gender and BMI-for-age on periodontal health were significant. In contrast, the effect of the interaction between gender and BMI-for-age on periodontal health was not it was not significant. Conclusions: In adolescents, bad oral hygiene was correlated with extra body fat indicators. Therefore, oral health preventive schedules should take into consideration the relationship between periodontal condition and overweight/obesity in teenagers.



Obesity; Body mass index; Periodontal disease; Oral health status.


World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on obesity & World Health Organization (WHO Technical Report Series 894). Geneva, Report 2000.

Kopelman PG. Obesity as a medical problem. Nature. 2000; 404(6778):635-43.

Fadel HT, Pliaki A, Gronowitz E, Marild S, Ramberg P, Dahlen, et al. Clinical and biological indicators of dental caries and periodontal disease in adolescents with or without obesity. Clin Oral Investig. 2014; 18(2):359-68.

Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006; 1(1):11-25.

Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. 2010; 375(9727):1737-48.

World Health Organization. Countrywide Integrated Non-communicable Diseases Intervention (CINDI) Programme. Report 1995.

Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005; 83(9)661-9.

Lopez R, Fernandez O, Baelum V. Social gradients in periodontal diseases among adolescents. Community Dent Oral Epidemiol. 2006; 34, 184–196.

Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2000. 2013; 62(1):59-94.

Al-Zahrani MS, Bissada NF, Borawskit EA. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol. 2003; 74(5):610-5.

Larson NI, Story M. The pandemic of obesity among children and adolescents: what actions are needed to reverse current trends? J Adolesc Health. 2007; 41(6):521-2.

Alabdulkarim M, Bissada N, Al-Zahrani M, Ficara A, Siegel B. Alveolar bone loss in obese subjects. J Int Acad Periodontol. 2005; 7(2):34-8.

Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol. 2005; 76(11 Suppl):2075-84.

Ekuni D, Yamamoto T, Koyama R, Tsuneishi M, Naito K, Tobe K. Relationship between body mass index and periodontitis in young Japanese adults. J Periodontal Res. 2008; 43(4):417-21.

Range H, Poitou C, Boillot A, Ciangura C, Katsahian S, Lacorte J, et al. Orosomucoid, A new biomarker in the association between obesity and periodontitis. PLoS One. 2013; 8(3):e57645.

Lewis CW, Johnston BD, Linsenmeyar KA, Williams A, Mouradian W. Preventive dental care for children in the United States: a national perspective. Pediatrics. 2007; 119 (3) e544-e53

Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA. Periodontitis-systemic disease associations in the presence of smoking-causal or coincidental? Periodontol 2000. 2002; 30:51-60.

World Health Organization. Oral health survey: basic methods, 4th edition. WHO. Geneva 1997.

Macek MD, Mitola DJ. Exploring the association between overweight and dental caries among US children. Pediatr Dent. 2006; 28(4):375-80.

World Health Organization. Physical status: the use and interpretation of anthropometry: Report of a WHO Expert Committee. WHO Technical Report Series 854, World Health Organization, Geneva 1995.

Garnick JJ, Silverstein L. Periodontal probing: probe tip diameter. J Periodontol. 2000; 71(1):96-103.

Suresh S, Mahendra J. Multifactorial relationship of obesity and periodontal disease. J Clin Diagn Res. 2014; 8(4):ZE01-3.

Oppermann RV, Weidlich P, Musskopf ML. Periodontal disease and systemic complications. Braz Oral Res. 2012; 26 Suppl 1:39-47.

Modeer T, Blomberg C, Wondimu B, Lindberg TY, Marcus C. Association between obesity and periodontal risk indicators in adolescents. Int J Pediatr Obes. 2011; 6(2-2):e264-70

Irigoyen-Camacho ME, Sanchez-Perez L, Molina-Frechero N, Velazquez-Alva C, Zepeda-Zepeda M, Borges-Yanez A. The relationship between body mass index and body fat percentage and periodontal status in Mexican adolescents. Acta Odontol Scand. 2014; 72(1):48-57

Dixon JB, O Brien P. A disparity between conventional lipid and insulin resistance markers at body mass index levels greater than 34 kg/m2. Int J Obes Relat Metab Disord. 2001; 25(6):793-7.

Lamas O, Marti A, Martinez JA. Obesity and immunocompetence. Eur J Clin Nutr. 2002; 56:S42–5.

28. Kawanami D, Maemura K, Takeda N, Harada T, Nojiri T, Imai Y, et al. Direct reciprocal effects of resistin and adiponectin on vascular endothelial cells: a new insight into adipocytokine endothelial cell interactions. Biochem Biophys Res Commun. 2004; 314(2):415-9.

Scorzetti L, Marcattili D, Pasini M, Mattei A, Marchetti E, Marzo G. Association between obesity and periodontal disease in children. Eur J Paediatr Dent. 2013; 14(3):181–4.

Reeves AF, Rees JM, Schiff M, Hujoel P. Total body weight and waist circumference associated with chronic periodontitis among adolescents in the United States. Arch Pediatr Adolesc Med. 2006; 160(9):894-9.

Das UN. Is obesity an inflammatory condition? Nutrition. 2001; 17(11-12):953-66.

Ahima RS, Flier JS. Adipose tissue as an endocrine organ. Trends Endocrinol Metab. 2000; 11(8):327-32.

Greenburg AS, Obin MS. Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr. 2006; 83(2):461S–465S.

Sarlati F, Akhondi N, Ettehad T, Neyestani T, Kamali Z. Relationship between obesity and periodontal status in a sample of young Iranian adults. Int Dent J. 2008; 58(1):36-40.

Kinane FD, Hodge PJ. Periodontal disease in children and adolescents: introduction and classification. Periodontol 2000. 2001; 26:7-15.

Lundin M, Yucel-Lindberg T, Dahllof G, Marcus C, Modeer T. Correlation between TNF-alfa in gingival fluid and body mass index in obese subjects. Acta Odontol Scand Acta Odontol Scand. 2004; 62(5):273-7.

Franchini R, Petri A, Migliario M, Rimondini L. Poor oral hygiene and gingivitis are associated with obesity and overweight status in pediatric subjects. J Clin Periodontol. 2011; 38(11):1021-8.

Thomson WM, Sheiham A, Spencer AJ. Sociobehavioral aspects of periodontal disease. Periodontol 2000. ; 60(1):54-63.

AlJehani YA. Risk factors of periodontal disease: review of the literature. Int J Dent. 2014; 2014:182513.

Laine MA. Effect of pregnancy on periodontal and dental health. Acta Odontol Scand. 2002; 60(5):257-64.

Jeffcoat M, McGuire M, Newman M. Evidence-based periodontal treatment. Highlights from the 1996 World Workshop in Periodontics. JADA 1997;713-724






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