title: Obesity and cumulative inflammatory burden: a valuable risk assessment parameter in caring for dental patients.
abstract: A new model of risk assessment that recognizes the importance of reducing patients' cumulative inflammatory burden by targeting overweight and obesity, in individuals with periodontal disease, may be a valuable risk assessment parameter in caring for dental patients.
  
  
  BACKGROUND
  The growing body of evidence that suggests obesity, Metabolic Syndrome and periodontal disease are interrelated offers an unprecedented opportunity to adopt a new model of risk assessment that has the potential to beneficially influence not only the periodontal health of obese and overweight patients, but simultaneously may also reduce a person's overall risk for developing heart disease and type 2 diabetes, and perhaps other inflammatory driven disease states.
  
  
  METHODS
  This paper presents an overview of research that builds the case for a new model of risk assessment that focuses on the cumulative inflammatory burden that may be elevated by the presence of periodontal disease in obese patients. In addition, the biological plausibility of the concepts of inflammatory priming and inflammatory loading is discussed, and several simple ideas are suggested for identifying at-risk patients.
  
  
  CONCLUSIONS
  Given the significant rise in obesity and the impact that obesity has on periodontal health and other inflammatory driven, systemic disease states, adoption of a new model of risk assessment is suggested-one that considers an individual's cumulative inflammatory burden which may be amplified as a result of coexisting obesity and other components of Metabolic Syndrome and periodontal disease. Knowledge gathered thus far combined with further clinical research must be translated into better ways to treat and maintain obese periodontal patients. These measures may pave the way for prevention of metabolic diseases and obesity with a relevant impact on patients' periodontal status.
authors.affiliation: Division of Periodontics, International Centre for Oral-Systemic Health, College of Dentistry, University of Manitoba, Canada; Division of Continuing Professional Development, College of Medicine, Faculty of Health Sciences, University of Manitoba, Canada; Casey Hein & Associates, USA. Electronic address: casey.hein@med.umanitoba.ca.
authors.forename: Casey
authors.initials: C
authors.lastname: Hein
authors.affiliation: Division of Periodontics, Department of Dental Diagnostics & Surgical Sciences and Department of Oral Biology, College of Dentistry, Faculty of Health Sciences, University of Manitoba, Canada.
authors.forename: Eraldo L
authors.initials: EL
authors.lastname: Batista
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D006331:Heart Diseases / Q000517:prevention & control; D006801:Humans; D007249:Inflammation / Q000503:physiopathology / Q000517:prevention & control; D024821:Metabolic Syndrome / Q000517:prevention & control; D009765:Obesity / Q000517:prevention & control*; D050177:Overweight / Q000517:prevention & control; D010510:Periodontal Diseases / Q000517:prevention & control*; D018570:Risk Assessment
keywords: Obesity related periodontal disease; cardiometabolic risk; cumulative inflammation; proinflammatory hyper-response