Is there a prospective association between obesity and periodontal disease?

Objective: To evaluate the prospective association between measures of adiposity and self-reported periodontal disease.

Methods: We analyzed data from 36,903 men from the Health Professionals Follow-Up Study, free of reported periodontal disease at baseline, and followed for up to 16 years (1986-2002). Height was assessed at baseline, and weight and self-reported periodontal disease data were collected at baseline and on biennial follow-up questionnaires. Waist and hip circumference were self-assessed and reported in 1987 with the aid of printed instructions and a tape measure. Self-reported periodontal disease and adiposity measures have been previously validated. We used Cox proportional-hazards models to evaluate the multivariate adjusted relation between body mass index (BMI kg/m2), waist circumference (WC) and waist-to-hip ratio (WHR), and first report of periodontal disease diagnosis.

Results: 3,340 new periodontal disease diagnoses were reported from 543,476 person-years. Significant associations and trends were observed between all measures of adiposity and periodontal disease after adjusting for age, smoking, race, dental profession, physical activity, fruit and vegetable intake and diabetes status at baseline. Obesity at baseline (BMI>=30 vs. 18.5-24.9) and over follow-up were significantly associated with increased hazards of periodontal disease (HR=1.25; 95% CI: 1.10-1.42; HR=1.29, 95% CI: 1.15-1.45, respectively). WC>=40inches compared to <40inches was significantly associated with an increased incidence of periodontal disease (HR=1.19, 95% CI: 1.07-1.31). WHR>=0.95 compared to <0.95 exhibited a significant positive association with incidence of periodontal disease (HR=1.16, 95% CI: 1.07-1.27). Adjusting for BMI attenuated WC and WHR. The observed associations of BMI and waist circumference were significant even among non-diabetics and among never smokers.

Conclusion: These results provide the first prospective evidence to support an association between obesity and risk of periodontal disease. Given the high prevalence of excess adiposity and periodontal disease this association may be of substantial public health importance.

Support: NIH-R25GM55353, K24-DE016884-03