What is the relationship between obesity and dental caries? A systematic review

This summary is adapted from the article published in the journal of Community Dentistry and Oral Epidemiology: Obesity and Dental Caries in Children: A Systematic Review and Meta-Analysis

Childhood obesity is a global health problem and  a multifactorial disorder, influenced by environmental and genetic risk factors, where a sustained imbalance between energy intake and energy expenditure facilitates storage of excess energy as fat. Consequently, poor diet is a primary determinant of obesity. 

Poor oral health is characterized by the onset of dental caries, considered the most common chronic disease found in children. Diet specifically through the frequent consumption of monosaccharide (e.g. glucose, fructose) and disaccharide (e.g. sucrose) sugars is the predominant cause of dental caries. 

The lack of relationship between BMI and dental caries could be explained by the frequency of sugar ingestion (resulting in development of dental caries) rather than the amount per se and acknowledge dietary fat as an important promoter of obesity.

Conflicting findings in the literature to date suggest that the relationship between obesity and dental caries in children is likely to be complex and potentially hindered by amalgamation of multiple age groups that differ considerably in growth rate and expressed phenotype as well as the differential rates of growth that are expressed in children within an age group.

Results 

• When analysed by dentition type (primary versus permanent), there was a non-significant association of obesity and dental caries in permanent and primary dentitions. Yet, on accounting only for standardized definitions for assessment of child obesity using body mass index, a strong significant relationship was evident in children with permanent dentitions.
• Moderating for study country of origin (newly ‘industrialized’ versus industrialized) showed a significant relationship between obesity and dental caries in children from industrialized but not newly industrialized countries. Cofactors such as age and socioeconomic class were significant moderators.

Conclusion

Future analysis is needed to investigate these confounding variables, helping shape the future of obesity management programs and oral health interventions, through determining common risk factors.

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