Obesity and oral health: two preventable problems with one set of weapons neededNews
Posted by: The Probe 31st January 2019
Reseach shows that good oral hygiene habits might go a long way in helping patients trying to lose weight.
The link between obesity and poor oral health is well established. Being drastically overweight has obvious consequences if you want to stay orally healthy, as well as thriving in mind and body.
Rising levels of obesity are causing a crisis in public health and placing a huge strain on healthcare institutions and the people who work in them. Obesity is linked with high blood pressure, coronary heart disease, type 2 diabetes and is associated with 13 types of cancer. In fact, in the UK, it is the biggest cause of cancer after smoking. In England alone, there were an astonishing 617,000 hospital admissions where obesity was a factor during 2016/17, which is an increase of 18 per cent from 2015/16. To give the picture worldwide, the World Health Organisation (WHO) says obesity has nearly tripled since 1975. Of the 1.9 billion adults across the world defined as ‘overweight’, 650 million would be classified as ‘obese’, which means they have a Body Mass Index (BMI) of 30 or above (these statistics relate to 2016). The picture for our children is bleak too; according to the WHO’s figures, 340 million five to 19-year-olds were either overweight or obese in 2016.
Unhealthy, high sugar diets predispose patients of any age to caries. Too many sugary drinks can mean they also suffer from xerostomia and/or halitosis. If the individual is older, their excess weight on the stomach area may mean more gastric reflux, and therefore more acid in the oral
cavity. A trip to the dentist is likely to be an uncomfortable experience, physically and mentally. Fear of the dental consequences of their poor nutritional status would be a reason for an obese patient choosing to stay away.
If someone is overweight, they have a greater possibility of developing periodontal problems. Again, research has been out there for a while on this topic; obesity is a significant, modifiable risk factor for this silent, yet destructive disease. Arguably, though, many patients do not quite understand what periodontitis is, or what its impact could be. TV adverts tell them to see a dentist if there is blood when they brush, but because bleeding is not usually accompanied by any pain, and may not happen every time, it becomes easy to dismiss. The difference between gingivitis and periodontitis is not always understood either, although the former is non-destructive and may not even progress to the latter if it is diagnosed and halted in time. Preventive dentistry is all about education – helping patients understand the signs and impact of various dental problems in their own terms, so they are motivated in the ways to avoid them.
Obesity may be a risk factor for periodontal conditions, but a new piece of research from 2018 indicates that it may in fact be a two-way relationship. Scientists in New York conducted a study, which appeared to show that bacteria ‘found solely in the oral cavity’ could make obesity worse. So, being obese or overweight is a leading cause of periodontitis, which in turn can aggravate obesity. More research is needed, but the concept is fascinating.
Of course, there are many risk factors for periodontitis – such as smoking, types 1 and 2 diabetes, along with other genetic and environmental factors – but there is a clear relationship between obesity and periodontal problems. Obesity may be preventable and reversible, but tackling obesity requires a multi-disciplinary approach based on education delivered in an effective way. While governments and healthcare agencies at home and abroad put strategies in place to help change the culture around food by encouraging people to make better choices (in the UK, the imposition of a Sugar Tax; also the Childhood Obesity Plan), dental practitioners must think about what they can do to help patients in the very local, and far more relatable, confines of their own practice.
Good cleaning and regular appointments are the absolute bedrock of the prevention and the effective management of serious dental conditions, such as periodontitis. And if we take into consideration new research, better oral hygiene habits might even help a patient who is trying to lose weight. Back to basics we go then, to clear and consistent advice about diet and nutrition and practical tips about how to clean properly using only the highest quality tools and adjuncts. Regular dental appointments should include visits to the hygienist, who will also be able to advise on correct technique. Interdental brushing is an effective weapon for preventing periodontal conditions; the Tandex FLEXI
can get into interproximal spaces without causing trauma to this sensitive area and is an easy tool to master with guidance.
Obesity and periodontitis are long-term bedfellows, and both are preventable with the right support and advice. Management of both will improve your patients’ all-round wellbeing and help them on the path to a healthier life.
For more information on Tandex’s range of products, visit www.tandex.dk and www. facebook.com/pages/Tandex-UK
About the author
Rachel Pointer qualified from Guys Hospital as a dental hygienist and began work in general dental practice in Hertfordshire. After working as staff hygienist for Professor Naylor, she was appointed tutor dental hygienist at Guy’s Hospital before working in Australia.
Rachel has experience in hospital, specialist periodontal practice and in the private sector, as well as setting up a PDU within a cerebral palsy home in Essex. She worked for the British Dental Hygienists’ Association for 10 years as their information officer plus membership and careers co-ordinator.
Rachel currently works at Addenbrooke’s Hospital and in general dental practice and has branched out to teach in a Montessori school setting.