Individuals with High Body Mass Index Prone to Overgrowth of Oral Bacteria
January 22, 2009
In a recent research study, which examined the differences in the periodontal health of individuals with different Body Mass Indices (BMI), Forsyth Institute scientists have found a connection between overweight and obese individuals and a particular gum disease-causing oral bacterium, termed Tannerella forsythia. T. forsythia occurs in the bacterial ’plaque’ of individuals with otherwise healthy mouths. This bacterial overgrowth may put these individuals at risk for gum disease in the future.
Previous published research has suggested a connection between obesity and periodontal disease. However, this is the first study to examine the relationship of obesity to the composition of the mouth’s bacterial plaque, and whether microbial shifts in obese individuals might be associated with increased risk of developing severe gum disease. More than 80 percent of the adult population in the United States has periodontal disease, which can lead to bone and tooth loss and also impact systemic health conditions. This study, which was published in Journal of Clinical Periodontology online on January 16, 2008 was led by Dr. Anne Haffajee, head of the Department of Periodontology at The Forsyth Institute.
Dr. Haffajee found that subjects, particularly younger females who were overweight or obese, were at greater risk for periodontitis than subjects with a normal BMI after adjusting for age, gender and smoking status. The periodontal pathogen, T. forsythia, was in greater proportions in periodontally healthy subjects who were obese, potentially increasing their risk of developing periodontitis. “This increased risk for developing periodontal disease in younger, obese individuals provides an important opportunity for prevention,” said Dr. Haffajee. “These individuals should be monitored and provided with aggressive preventive measures and/or treatment to prevent initiation or progression of periodontitis.”
Summary of Study 121 periodontally healthy/gingivitis and 574 chronic periodontitis subjects were weighed, had their height determined and monitored at 6 sites per tooth for probing pocket depth, clinical attachment level, bleeding on probing, gingival redness and presence of visible plaque. Subgingival plaque samples taken from each tooth were individually analyzed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization. The only bacterial species seen in different proportions among high BMI groups was T. forsythia. This suggests that a change in periodontal tissue status that is due to metabolic changes associated with obesity might affect microbial colonization patterns in the mouth and compromise host tissue defenses, altering the progression of periodontal disease. More work needs to be done to examine differences such as dietary pattern, lifestyle, oral habits and genetic background between obese and non-obese individuals. However, the recognition of an association among obesity, periodontal disease and increased colonization by the periodontal pathogen, T. forsythia, may be the first step in attempting to unravel the biologic mechanisms underlying this association. Anne D. Haffajee, BDS, is a Senior Member of the Staff at The Forsyth Institute and Head of the Department of Periodontology. Her lab focuses on examining the microbial ecology of the oral cavity; the effects of different periodontal therapies on clinical and microbial parameters of disease; and developing and improving techniques to examine microbial and host factors associated with periodontal diseases. This work was supported in part by research grants from the National Institute of Dental and Craniofacial Research. The Forsyth Institute is the world’s leading independent organization dedicated to scientific research and education in oral health and related biomedical sciences.