Obesity is defined as abnormal accumulation of fat that presents a risk to health. World Health Organisation (WHO) refers to it as having a Body Mass Index (BMI) of 30. In 2017 WHO declared that obesity has reached epidemic proportions with 4 million people dying every year due to obesity and associated complications. In 2016 alone 1.9 billion people were obese world-wide.

It is well known that obesity has a systemic effect on the body with a direct link to:

• Diabetes Mellitus
• Cardiovascular diseases (myocardial infarction, stroke)
• Hyperlipidaemia
• Osteoarthritis 
• Some types of cancers. 

Obesity is said to increase morbidity and mortality through its multiple effects on almost every system in human body(1) with obese patients more likely to develop post-operative infections and complications compared to average weight individuals.

WHO has categorised obesity as a non-communicable disease affecting overall health and quality of life of an individual. Epidemiological studies show that there is a relationship between obesity/BMI and tooth loss in elderly and middle aged individuals (2) However, studies also show that an unhealthy diet and lifestyle is an associated risk for oral disease (including decay and periodontal disease) (3).

Research shows that adipose tissue is an active participant in immunity and inflammation (4). While adipose tissue (seen lately as an endocrine organ in itself) is a source of energy it also produces and releases a variety of pro-inflammatory and anti-inflammatory factors such as adipokines, leptin, adiponectin as well as cytokines and chemokines (some also found in periodontitis) causing an imbalance and a low-grade inflammatory state.

Adiponectin is potentially immunosuppressive while leptin activates the PMN’s (5). Adipokines include tumour necrosis alpha (TNFa) and interleukins which can help in wound healing. Research also shows that the serum and gingival crevicular fluid is altered in obese individuals as there is an increase in interleukins and TNFa (4).

Periodontitis (a non-communicable disease itself) is defined as an infection of the supporting structures of the teeth as a result of the active between bacteria and immune response. As shown above obesity not only creates a low grade inflammation but also produces inflammatory mediators well known for their role in bone periodontal destruction therefore aiding in the initiation of periodontitis (2).

Year 2020 has been defined by the SARS-Cov-2 pandemic. Globally countries have come together to try and prevent or treat and, if possible, eradicate this new virus by better treatments, research into vaccination and restrictions applied locally or on a national level.

Obesity is said to have an impact on the treatment and complications. So once again obesity has hit the spotlight and governments have started talking about methods to control this by different means.

In fighting to prevent and stabilise periodontal disease one needs to address the overall health, and this includes weight problems.

As dental professionals we are in a unique position to aid with this worldwide problem. Behavioural factors can determine whether oral diseases will develop or not (6) and we already are using health behaviour change techniques and are well equipped in giving diet advice and oral hygiene instructions to help in tooth decay, tooth wear and periodontitis prevention. From this position we can easily link oral diseases to general health and obesity (7).