You know the age-old quandary, “Which came first, the chicken or the egg?” It’s a good reminder of how science isn’t always about finding one definitive answer. It can also provide a lens to see unique relationships.
So let’s rephrase the question: Which comes first, obesity or gum disease? Though both are marked by chronic inflammation, two recent studies suggest that it may be obesity – a disease in and of itself, according to the American Medical Association.
The first, published this past March in Medicine, looked at relationships between gum disease and the oxidative stress associated with obesity. Analyzing data from 40 young women – 20 lean, 20 obese – the authors found that the latter rated higher for markers of early gum disease, such as gingival bleeding and tissue damage. (“Gingival” refers to gum tissue, a/k/a the gingiva.)
Periodontal health, in turn, was correlated with body mass index, insulin and lipid levels, and oxidant status.
Our results suggest that young obese, otherwise healthy, women show findings of early periodontal disease (gingival inflammation) compared with age-matched healthy lean women, and that local/periodontal oxidative stress generated by obesity seems to be associated with periodontal disease.
In the other study, researchers looked at advanced gum disease in obese Malaysian men. How common was it? What, if anything, predicted it? So they analyzed data from questionnaires, as well as typical measurements of periodontal health: visual plaque, bleeding, pocket depth, and clinical attachment loss.
The result? Gum disease was indeed far more common in this group. Gingival bleeding and visible plaque were predictive.
Chronic gum disease is a major oral health issue, affecting 30 to 35% of the global population. Up to 80% of Americans have it to some degree, early or severe. In its worst form, gum disease is a leading reason for tooth loss. And tooth loss comes with its own risks for disease and death.
Obesity, of course, is rampant, as well – and not just here in the US. It’s estimated that one-quarter of all adults, worldwide, meet the BMI mark for obesity. And studies show that
Obesity is a potential risk factor for major complex diseases such as diabetes, cardiovascular diseases, metabolic syndromes as well as chronic periodontitis.
So which comes first, the obesity or disease?
Well, if obesity, like the chicken, does, we’ll need to understand the mechanisms – and observe the consequences of what hatches next.
Image by W_Minshull, via Flickr