Effect of Periodontitis and Toothbrushing Frequency on Obesity Onset: A Cohort Study

The association between tooth brushing during lunchtime and obesity in South Korean adolescents

Obesity in adolescents is a global health concern associated with several diseases and complications in adulthood. Obesity has been reported to be strongly associated with oral habits. To investigate the association between tooth brushing during lunchtime and the prevalence of obesity among adolescents in a nationally representative sample of South Korean adolescents. Data from the 2018-2021 Korea Youth Risk Behavior Web-Based Survey were used in this cross-sectional study. Obesity was measured based on the body mass index. The chi-square test was used to investigate and compare tooth brushing habits during lunchtime in the study population, and multivariate logistic regression analysis was performed to analyze the relationship between tooth brushing during lunchtime and the prevalence of obesity. The odds of obesity were lower in the group that brushed their teeth during lunchtime (adjusted odd ratio: 0.90, 95% confidence interval: 0.88-0.93). Furthermore, the odds of obesity were significantly higher in high school students; boys; those with a low household income, low subjective health status awareness, medical history (asthma or atrophy), and history of sealant use; and those who responded after the coronavirus disease 2019 pandemic. A significant inverse relationship was found between tooth brushing habits during lunchtime and the prevalence of obesity. This relationship was consistent regardless of socioeconomic and lifestyle factors.

Impact of dental health intervention on cardiovascular metabolic risk: a pilot study of Japanese adults

This study aimed to determine whether a dental health education program would reduce cardiometabolic risk (obesity, hypertension, dyslipidemia, and hyperglycemia) in people with periodontitis. We used annual check-up data provided by the Japanese company's health insurance union. Of 182 male employees with cardiometabolic risk and periodontal pockets at baseline, 21 participants of the dental health education program and 21 non-participants matched for age, the presence of obesity, and periodontal pocket at baseline were allocated to the intervention (mean age, 53.3 ± 7.0) and the non-intervention groups (mean age, 52.9 ± 7.0), respectively. The program focused on self-removal of dental plaque with a toothbrush and interdental brush and comprised five sessions over 12 months. In the intervention group, waist circumference (cm) and diastolic blood pressure (mmHg) decreased from 88.4 ± 6.3 to 86.8 ± 6.3 and from 85.7 ± 8.2 to 82.6 ± 8.3, respectively (P < 0.05). Intergroup comparison showed significant improvement of systolic blood pressure (mmHg) in the intervention group (-3.7 ± 12.5) compared with the non-intervention group (4.0 ± 15.9) (P < 0.05) with no significant differences in the other parameters. The intervention group had a decrease in plaque accumulation and periodontitis symptoms, such as the depth of periodontal pocket and the presence of periodontal pocket and bleeding on probing, but an increase in the frequency of interdental brushing and duration of tooth brushing. Our findings show that dental self-care may improve blood pressure in people with cardiometabolic risk factors and periodontitis.

Association between Periodontal Condition and Fat Distribution in Japanese Adults: A Cross-Sectional Study Using Check-Up Data

Some studies have reported a significant association between periodontal condition and obesity status. We hypothesized that visceral fat area (VFA) and subcutaneous fat area (SFA) volumes might be correlated with periodontal condition. The purpose of the present cross-sectional study was to investigate the association between periodontal condition and fat distribution in Japanese adults. A total of 158 participants, aged 35-74 years, underwent a health check-up including fat distribution and oral examinations. All of the participants underwent magnetic resonance imaging to quantify VFA and SFA. Periodontal condition was evaluated using the periodontal pocket depth (PPD) and clinical attachment level. The VFA volumes differed among the PPD score and clinical attachment level (CAL) code groups. On the other hand, no significant differences in SFA volume were observed among different periodontal conditions. Multiple regression analysis showed that VFA was positively correlated with a greater CAL (standardized coefficient β = 0.123, p = 0.009), but not with a greater PPD score. A larger VFA was positively associated with a greater CAL in Japanese adults, whereas no association was found between SFA and periodontal condition.

Obesity and periodontitis: A systematic review and updated meta-analysis

Background

A previous 2014 meta-analysis reported a positive association between obesity and periodontitis. It was considered necessary to update the recently published papers and to analyse subgroups on important clinical variables that could affect the association between obesity and periodontitis. Therefore, we updated the latest studies and attempted to derive more refined results.

Methods

All observational studies were eligible for inclusion. The Newcastle-Ottawa scale was used to qualitatively evaluate the risk of bias. Subgroup analyses were conducted for patients aged 18-34, 35-54, and 55+ years and the countries (European countries, USA, Brazil, Japan, Korea, and other Asian countries).

Results

Thirty-seven full-text articles were included. Obesity conferred increased odds of periodontal disease with an odds ratio (1.35, 95% CI: 1.05-1.75). In the subgroup analysis by age, the odds ratio was the highest in the 18-34 years group (2.21, 95% CI: 1.26-3.89). In the subgroup analysis by country, European countries had the highest odds ratio (2.46, 95% CI: 1.11-5.46).

Conclusion

Despite the differences in degree, a positive association between obesity and periodontitis was found regardless of country or age. Therefore, medical professionals should try to prevent periodontitis by controlling patient weights, and more studies should be conducted to determine the association between obesity and oral health.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42022301343.

Associations with oral health indices for obesity risk among Japanese men and women: results from the baseline data of a cohort study

Background

Oral health is composed of various oral health indices (OHIs), such as oral self-care habits, oral hygiene, oral function, and mastication ability. Oral self-care habits have frequently been examined for obesity risk. This study aimed to comprehensively clarify the association between OHIs and obesity risk.

Methods

We collected data for 15 questions on the four OHIs and measured the body mass index of 3494 men and 2552 women aged 35–79 years. Obesity was defined as a body mass index ≥25 kg/m². The four OHIs were scored by the corresponding questions (good as “reference”), and the summed score was defined as “comprehensive OHI”, that is, the fifth OHI. Each lowest tertile score was used as “reference”. Using multiple logistic regression analysis, odds ratios (ORs), 95% confidence intervals (CIs), and p-values for trends were estimated.

Results

In the men and women, the ORs were 1.37 (1.11–1.67, < 0.01) and 2.48 (1.80–3.42, < 0.01) for oral self-care habits, and 1.78 (1.42–2.24, < 0.01) and 3.06 (2.12–4.43, < 0.01) for tooth brushing frequency, respectively. Moreover, in men, a significant trend was found for “harder rinsing out your mouth”, related to “oral function”. In women, the ORs were 1.74 (1.28–2.36, < 0.01) and 1.43 (1.00–2.06, < 0.01) for “comprehensive OHI” and “longer meal time” related to “mastication ability”, respectively.

Conclusions

Our findings showed that obesity risk was associated with poor of oral health, which were comprehensively composed of various OHIs, among middle-aged and older Japanese men and women.

Lifestyle Risk Factors and the Population Attributable Fractions for Overweight and Obesity in Chinese Students of Zhejiang Province

Objectives: To assess the relationship between modifiable lifestyle factors and risk of overweight/obesity in Chinese students, and to evaluate the predicting prevalence of overweight if the lifestyle risk factors were removed. Methods: A cross-sectional survey was conducted among 40,141 students in grade three and above (8-24yrs) in 2019 in Zhejiang Province, China. Physical examination was performed, and a self-administered questionnaire was used to collect lifestyle information, including dietary behavior, physical activity, TV watching, sleeping, smoking, drinking, and tooth-brushing habits. Logistic regression models were performed to assess the relationship between overweight/obesity and a series of lifestyle factors. Population attributable fractions (PAFs) were used to calculate the predicting prevalence of overweight/obesity if lifestyle risk factors were removed. Results: The prevalence of overweight/obesity of participants was 25.5% (male 32.3%, female 18.1%). Overweight/obesity were associated with adverse lifestyle factors, such as watch TV ≥1 h/day (OR = 1.14, 95% CI: 1.11-1.22), insufficient sleep (OR = 1.14, 95% CI: 1.11-1.22), and irregular toothbrushing habits (OR = 1.19, 95% CI: 1.01-1.39). Based on the calculated PAFs, the predicted prevalence of overweight/obesity would decline moderately if lifestyle factors were modified, with the magnitudes of decrease vary by sex, age and residence. Generally, a larger reduction was estimated if the sleeping time was increased and TV time was reduced, with the prevalence of overweight/obesity decreased by 1.1% (95% CI: 0.7, 1.5%) and 0.9% (95% CI: 0.6, 1.2%), respectively. Conclusions: Predicted prevalence of overweight/ obesity in Chinese students may decrease if modifiable lifestyle risk factors were removed. The attributable risk for obesity of lifestyle behaviors varied in age, sex and residence groups. The findings of this study may provide insights for planning and optimizing future obesity intervention endeavors.