Association between Obesity and Periodontitis in US Adults: NHANES 2011-2014

Abstract

Introduction: It is controversial whether obesity and periodontitis are related. A representative US population was examined for the relationship between obesity and periodontitis.

Methods: In the National Health and Nutrition Examination Survey (NHANES) 2011-2014, participants (n = 6,662) aged 30 years or older and who underwent periodontal examinations were chosen for analysis. An assessment of obesity was based on body mass index (BMI) and waist circumference (WC). Estimates of obesity and periodontal disease were made using univariate and multivariate logistic regression models.

Results: According to an adjusted odds ratio (OR) for periodontitis, BMI (OR = 1.01, 95% CI: 1.01∼1.02) and WC (OR = 1.01, 95% CI: 1∼1.01) were significantly associated with periodontitis, respectively. After adjusting for confounding factors, the OR for patients with high WC with periodontitis was 1.18 (1.04∼1.33) compared to normal WC. BMI and WC subgroups showed no significant interaction (p for interaction >0.05), except for the age interaction in BMI. Among young adults aged 30-44 years, obesity was significantly associated with periodontitis in subgroups; the adjusted OR for having periodontal disease was 1.02 (1∼1.03) and 1.01 (1∼1.02) for subjects with BMI and WC, respectively. When all covariates were adjusted, BMI ≥30 kg/m2 was statistically significantly associated with prevalence of periodontal disease among people aged 30-44 years (p < 0.001).

Conclusions: BMI and WC are significantly associated with periodontitis, even after adjusting for many variables, and were equally significant in obese (BMI ≥30 kg/m2) young people (30-44 years).

Keywords: Body mass index; National Health and Nutrition Examination Survey; Obesity; Periodontitis; Waist circumference.

Fig. 1.

Flowchart detailing the selection process for patients included in this retrospective analysis.

Fig. 2.

The relationship between BMI and periodontitis according to basic features. Except for the stratification component itself, each stratification factor was adjusted for all other variables (age, sex, race/ethnicity, education level, marital status, alcohol status, time since last dental visit, physical activity, sleep time, family income, smoking status, how many days used dental floss, days used mouthwash for dental problem, arthritis, gout, congestive heart failure, coronary heart disease, angina pectoris, stroke, thyroid disease, diabetes, hypertension, energy consumption, fat consumption, cholesterol consumption, protein consumption, sugar consumption, and dietary fiber consumption). Missing value groups are not shown.

Fig. 3.

The relationship between WC and periodontitis according to basic features. Except for the stratification component itself, each stratification factor was adjusted for all other variables (age, sex, race/ethnicity, education level, marital status, alcohol status, time since last dental visit, physical activity, sleep time, family income, smoking status, how many days use dental floss, days used mouthwash for dental problem, arthritis, gout, congestive heart failure, coronary heart disease, angina pectoris, stroke, thyroid disease, diabetes, hypertension, energy consumption, fat consumption, cholesterol consumption, protein consumption, sugar consumption, and dietary fiber consumption). Missing value groups are not shown.