Obesity, Skeletal Maturation and Dental Development in Orthodontic Patients

Objectives: The prevalence of obesity in children and adolescents is a current public health concern. The aim of this study was to investigate the effect of body mass index (BMI) percentile on skeletal and dental maturity in orthodontic patients. 

Methods: A retrospective chart review of patients between 8 and 17 years of age seen for initial orthodontic records prior to July 31, 2009 was done until a sample of 540 subjects met inclusion criteria. Age, race, height and weight were recorded.  Cephalometric radiographs were used to rate skeletal maturation using the Cervical Vertebral Method (CVM), while panoramic radiographs were used to estimate dental age (DA) using the Demirjian method.  Age and gender specific BMI percentiles (CDC: www.cdc.gov/healthyweight/assessing/bmi/ ) were calculated from height and weight data.  Linear regression and logistic regression models were used to assess the effect of BMI percentile on dental age and CVM stage respectively. 

Results: 540 subjects met inclusion criteria, 27% of males and 32% of females were either overweight (BMI percentile = 85-95) or obese (BMI percentile >95).  CVM stage and dental age were both significantly more advanced in subjects with increased BMI percentile.  For dental age the coefficient for BMI percentile was 0.005 years per 1 unit increase (p<0.001) and the odds ratio for the effect of BMI percentile on CVM was 1.02 (p<0.001). 

Conclusions: Orthodontists should consider weight status when evaluating growing children and adolescents as it can effect skeletal and dental development.