Obesity and periodontal outcomes: a population-based cohort study in Brazil

Abstract

BACKGROUND: To investigate the effects of abdominal and general obesity on periodontal outcomes in a population-based cohort of Brazilian adults. METHODS: Abdominal and general obesity were assessed in 2009 (n=1,720) and 2012 (n=1,222). For abdominal obesity, a dichotomous variable was created: 1)eutrophic/lost weight; 2)obese/gained weight; for general obesity a categorical variable was created: 1)eutrophic/lost weight; 2)gained weight; 3)obese. Periodontal outcomes were: 1)Percentage of teeth with bleeding on probing (BOP) and 2)Combination of BOP and Attachment Loss (AL). Hypertension was set as mediator. Marginal structural models (MSM) were used to estimate the controlled direct effect of obesity on periodontal outcomes. RESULTS: 1,076 participants presented periodontal data. The total effect model showed that those with general obesity in the cohort period presented higher risk of unfavorable periodontal outcomes (RR 1.45 for AL and BOP in different teeth; RR 1.84 for AL and BOP in the same tooth). Estimates from MSM revealed an effect of general obesity on AL and BOP in different teeth (RR 1.44). No effect of general obesity was noted on percentage of BOP. Total effect of abdominal obesity increased the risk of AL and BOP in different teeth (RR 1.47), AL and BOP in the same tooth (RR 2.77), and percentage of BOP (Rate Ratio 1.49). In a MSM, those with abdominal obesity presented greater risk of AL and BOP in the same tooth (RR 2.16) and percentage of BOP (Rate Ratio 1.37). CONCLUSIONS: Abdominal obesity has a direct effect on unfavorable periodontal outcomes in marginal structural models.