Association between overweight/obesity and periodontitis in adults. A systematic review

Overweight and obesity have been suggested to be associated with periodontitis as published in studies and narrative summaries. This project presents results of a systematic review investigating the association between overweight or obesity (as defined by the World Health Organization) and periodontitis. Search strategy included electronic and hand searching to December 2009. Ovid MEDLINE, EMBASE, LILACS, and SIGLE were searched. RCTs, cohort, case-control and cross-sectional study designs that included measures of periodontitis and body composition were eligible. Duplicate, independent screening and data abstraction were performed. Meta-analyses were performed when appropriate. A total of 526 titles and abstracts were screened, resulting in 61 full text articles and abstracts assessed for eligibility with 33 being included. Nineteen studies provided sufficient information for inclusion in meta-analyses. Meta-analyses indicated statistically significant associations between periodontitis and body mass index (BMI) category obese OR 1.81(1.42, 2.30), overweight OR 1.27(1.06, 1.51) and obese and overweight combined OR 2.13(1.40, 3.26). In conclusion, these results support an association between BMI overweight and obesity and periodontitis although the magnitude is unclear. Additional prospective studies to further quantify, or understand the mechanisms, of this association are merited. There is insufficient evidence to provide guidelines to clinicians on the clinical management of periodontitis in overweight and obese individuals.