Study shows worsened dental caries after bariatric surgery

According to the World Health Organization, obesity worldwide has nearly tripled since 1975. More than a third of the world’s adult population were overweight in 2016, and 13% were obese. Additionally, a staggering 39 million children under the age of 5 (5.74%) were overweight or obese in 2020.

From a dental perspective, research has long shown that there is a correlation between obesity and periodontal disease owing to chronic inflammation that may trigger the breakdown of the supporting alveolar bone. Obesity is preventable, and dentists may soon be among those who could help tackle it, according to research published by Loughborough University.

In the present study, the researchers investigated the oral health of 118 individuals before and after treatment for morbid obesity, that is, a body mass index (BMI) of 40 kg/m² or more or of 35 kg/m² or more in combination with comorbidities such as diabetes. Treatment involved either bariatric surgery or medical treatment, including lifestyle interventions for dietary and behavioural changes, drug treatment and support regarding increased physical activity.

“Around 5,000 cases of obesity surgery are performed each year in Sweden alone, and the trend is increasing,” study author Dr Negin Taghat, a dentist for the Swedish public dental service at the county council for the Västra Götaland territory, said in a press release. “We were therefore interested in seeing whether there is any change in the oral health of these patients after surgery,” she explained.

The findings showed an association between higher BMI and increased caries. It was found that patients with the highest BMI values had a doubled frequency of caries. Additionally, the researchers reported that the average number of carious lesions on the enamel went from 15.0 to 19.1 in patients who had undergone surgery, whereas those who had received medical treatment showed a decrease in enamel lesions two years after treatment.

“We saw that almost half of individuals experienced poorer oral health,” Dr Taghat said. She continued: “Individuals who have undergone surgical obesity treatment may also experience a variety of oral symptoms and an impact on their oral quality of life.” These include dentine hypersensitivity, difficulty chewing and social discomfort.

Owing to the central role that healthcare professionals play in educating their patients, Dr Taghat highlighted the importance of the research findings for disease prevention. She noted: “Health professionals and dental professionals meet these patient groups in their everyday work. It is extremely important for staff to be aware that oral health can be affected by both obesity and obesity treatment so that preventive measures can be planned.”

The doctoral dissertation, titled On Oral Health Before and After Obesity Treatment, was published in 2023 by the Sahlgrenska Academy at the University of Gothenburg.

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