Overweight and obesity as risk indicators for periodontitis in adults

Background: Developed and developing countries are facing an obesity epidemic with various health consequences. Few studies have addressed the relationship between obesity and periodontal health. The present study assessed the association of overweight and obesity with periodontitis in Brazilian adults. Methods: A representative probability sample comprising 706 subjects aged 30 to 65 years from south Brazil was examined clinically and using a structured interview. Overweight and obesity were assessed by body mass index (BMI) using the World Health Organization (WHO) criteria. Individuals with >= 30% teeth with attachment loss >= 5 mm were classified as having periodontitis. Statistical analysis accounted for survey design, and separate analyses were performed for nonsmokers. Results: In this population, 60% and 65% of males and females, respectively, were overweight or obese. Periodontitis was observed in 50.7% and 35.3% of males and females, respectively. The percentage of males with periodontitis was similar in the overweight/obese individuals compared to those with normal weight. In females, there was a positive correlation between the BMI index and the occurrence of periodontitis, with a significantly (P < 0.05) higher prevalence of periodontitis in obese than in normal weight females. The multivariable analysis showed that obese females were significantly more likely (odds ratio = 2.1) to have periodontitis than normal weight females. A separate analysis for nonsmokers showed that obese females were approximately 3.4 times more likely to have periodontitis than the normal BMI group. There were no significant differences in the prevalence of periodontitis between BMI groups among smokers of both genders and in male non-smokers. Conclusions: Obesity was significantly associated with periodontitis in adult, non-smoker women. Overweight was not significantly associated with periodontitis. Smoking may attenuate the association of periodontitis with obesity.