Obesity and oral disease - a challenge for dentistry.

The prevalence of overweight and obesity is rising in many developed and developing countries and, most worryingly, among children. Within the EU, Scotland has the highest prevalence, more than twice that of the Netherlands, and in England almost a quarter of children now enter primary school either overweight or obese, rising to one in three on leaving at age 11 years. Whilst most epidemiological data is based on body mass index, this is not a reliable indicator of individual adiposity and morbidity risk. The association between excess adiposity and type 2 diabetes is well recognised and the latter carries implications for oral disease and dental treatment. Current research has not established a clear association between excess adiposity and caries prevalence, however, there is evidence for a higher prevalence of chronic periodontal disease in obese populations. There is some evidence that this is not mediated solely by diabetes, but by secretion by adipose tissue of chemical mediators of inflammation, including cytokines and hormones, which could modify the response of the periodontal tissues to the oral environment. Dental professionals must become aware of this growing problem, of the demands that the rising obesity prevalence will place on dental care services and the need for bariatric dental facilities. Together, with service providers, dental professionals must prepare for the challenge ahead.