Oral/Systemic Links: Obesity, Gum Disease, & Oral Cancer

by | Jun 28, 2023 | Oral Health, Periodontal health

overweight person standing on scaleWhen you think about the consequences of obesity, you might think about things like diabetes, heart disease, and joint pain. You probably don’t think about oral health problems.

A couple of recent studies may have you thinking a little differently.

We’ve actually known for some time now that obesity and gum disease are linked. Some studies have shown that overweight and obese people have double the incidence of periodontitis, the advanced form of gum disease in which tissue damage occurs. The relationship was most recently confirmed by a 2022 systematic review. This study also found that oral symptoms tended to be worse in obese patients with periodontitis compared to slimmer patients with the condition.

And this can translate to significantly higher treatment costs, as a new study in the Journal of the American Dental Association shows.

Wanting to understand the impact of obesity on periodontal treatment costs, researchers analyzed data from nearly 3500 patients who were examined at a US dental school between 2010 and 2019. Just under 40% of those patients were average weight; 36% were overweight; 25%, obese.

lifting lip to show bleeding gumsCompared to those in the average weight group, the others were more likely to have severe periodontal disease and diabetes (another condition linked to gum disease). They were also more likely to be women and tobacco users (the number one risk factor for gum disease).

And they paid a good deal more for their periodontal care. Once all variables were accounted for, “the difference in total costs for periodontal treatment was 27% greater for patients who were obese than for patients who were average weight.”

One noteworthy finding was that extra costs due to obesity were consistently higher than those for diabetes or smoking for any periodontal disease category. For example, a man with moderate periodontitis would see his periodontal treatment costs increase by $54 if he had diabetes, $72 if he was a smoker, and $78 if he was obese, they wrote.

But gum disease isn’t the only oral health consequence, which brings us to new research in Cell Reports. Obesity also appears to help establish a type of microenvironment that promotes tumor progression in oral cancers. How this happens, according to the study, rests in the relationship between saturated fatty acids, the STING-type-I interferon pathway (a signaling pathway that helps the immune system do its work), and a protein called NLRC3 that plays a role in the immune system.

“Myeloid cells in obese mice were insensitive to STING agonists and were more suppressive of T cell activation compared to the myeloid cells from lean hosts,” explained [lead author Dr. Yu Leo] Lei. This feature drove the loss of immune subsets that were crucial for anti-tumor immunity in the tumor microenvironment.

In other words, defenses against cancer went down.

The team also found that saturated fatty acids can block the STING pathway, by inducing a protein called NLRC3. In such an environment, some oral cancers may advance without detection by the immune system.

Of course, obesity is hardly the only risk factor for oral cancers. Others include tobacco use, heavy drinking, and HPV infection.

But because oral cancers tend to be readily treatable when caught early, regular screening is a crucial part of oral health care for all adults. In addition to being screened by your dentists, you can also do self-exams at home. Here’s how:

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