title: Clinical and biological indicators of dental caries and periodontal disease in adolescents with or without obesity.
abstract: OBJECTIVE
  This study aims to assess clinical, microbiological and inflammatory parameters as indicators for caries and periodontal disease in adolescents with obesity.
  
  
  METHODS
  Twenty-seven adolescents with obesity [body mass index (BMI) 37 ± 4 kg/m(2)] and 28 controls (BMI 20 ± 2 kg/m(2)) answered questionnaires and were investigated regarding salivary parameters, plaque pH drop after a 1-min glucose rinse, oral clinical parameters, inflammatory markers in gingival crevicular fluid (GCF) and sub-gingival mirobiota.
  
  
  RESULTS
  Compared with controls, adolescents with obesity had a lower stimulated salivary secretion rate (1.55 ± 0.63 vs. 2.05 ± 1.05 mL/min, p < 0.05), higher concentrations of secretory immunoglobulin A (sIgA) (p < 0.001), more decayed tooth surfaces (3.4 ± 6.6 vs. 0.8 ± 1.1, p < 0.05) and more gingivitis (p < 0.01) after controlling for possible confounders. Overall, similar snacking habits, plaque amounts and numbers of deep periodontal pockets were observed. Following the glucose rinse, a slightly more pronounced drop in plaque pH was observed in the obesity group (p > 0.05). No differences in sub-gingival inflammatory or microbial indicators were detected (p > 0.01).
  
  
  CONCLUSIONS
  More caries and gingival inflammation were observed in adolescents with obesity. Of the indicators tested, salivary secretion rate was lower and sIgA levels were higher in the obesity group. We are unable to confirm whether differences in caries and gingival inflammation are due to systemic changes that are associated with obesity or due to possible irregular dietary/oral hygiene habits.
  
  
  CONCLUSIONS
  Customised oral health preventive programmes and appropriate collaboration with medical personnel in selecting the best diet, medication and psychological support can help improve the general well-being, including oral health, of children with obesity. This may even reduce the risk of oral diseases.
authors.affiliation: Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden, hani.fadel@yahoo.com.
authors.forename: Hani T
authors.initials: HT
authors.lastname: Fadel
authors.forename: Anthi
authors.initials: A
authors.lastname: Pliaki
authors.forename: Eva
authors.initials: E
authors.lastname: Gronowitz
authors.forename: Staffan
authors.initials: S
authors.lastname: Mårild
authors.forename: Per
authors.initials: P
authors.lastname: Ramberg
authors.forename: Gunnar
authors.initials: G
authors.lastname: Dahlèn
authors.forename: Tülay
authors.initials: T
authors.lastname: Yucel-Lindberg
authors.forename: Lars
authors.initials: L
authors.lastname: Heijl
authors.forename: Dowen
authors.initials: D
authors.lastname: Birkhed
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D003731:Dental Caries / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D010510:Periodontal Diseases / Q000150:complications*; D011795:Surveys and Questionnaires