Obesity is a growing problem worldwide, and this trend has serious implications for an increased incidence of many chronic diseases, including cardiovascular diseases and diabetes.

Obesity is defined by body mass index (BMI), the ratio of an individual’s body weight in kilograms to the square of their height in meters. BMI values between 25.0 and 29.9 indicate overweight, whereas values of 30 or more define obesity.

This article provides a detailed overview of obesity as a disease, and examines its relationship to periodontal, and other chronic inflammatory diseases, presenting the most current research taken from cross-sectional studies. The authors’aim is to increase awareness about the significance of obesity as a potential risk factor for oral disease and related implications for managing overweight and obese persons in clinical practice.

As observed by the authors, recent epidemiologic studies estimate that obese subjects are between 1.4 and 8 times more likely to have deep probing pockets or extensive attachment loss compared to normal weight subjects. Overweight subjects also have elevated odds of periodontal disease. In contrast, subjects who maintain their weight through exercise and good dietary practices tend to have a lower prevalence of periodontal disease.

The underlying mechanisms for the association of obesity with periodontitis are not well known. The association may be partly a function of the fact that obesity is a strong risk factor for cardiovascular diseases and diabetes, common chronic diseases that may influence, and be influenced by, periodontal disease. Research findings suggest that cytokines released from adipose (fatty) tissue may indeed modulate periodontitis. Adipose tissue secretes pro-inflammatory cytokines, including TNF-α and interleukin-6, and elevated levels of these inflammatory markers are associated with obesity and insulin resistance. Patients with chronic periodontitis possess elevated levels of these same pro-inflammatory cytokines. Periodontal pathogens and their secreted endotoxins, along with these cytokines, trigger the synthesis and secretion of a variety of acute-phase proteins which increase risk for the development of multiple systemic diseases, including heart disease and type 2 diabetes.