Periodontal Disease Progression in Men who Gain Weight

Objectives: Determine if gains in weight and adiposity (body mass index (BMI), waist circumference (WC), and upper arm fat area (UAFA)) influence periodontal disease progression in males.

Methods: Participants were 893 non-diabetic, non-Hispanic white males in the VA Dental Longitudinal Study with no chronic medical disease at baseline (1968-73) and monitored with triennial oral and medical examinations over 3 decades. Subjects are not VA patients but receive medical and dental care in the private sector. Probing pocket depth was measured by calibrated examiners and periodontal disease (PD) defined as cumulative numbers of teeth ever exhibiting probing pocket depth ≥4mm. The distribution of annual weight change during follow-up was divided into tertiles. Repeated measures generalized linear models estimated mean PD at each examination and slopes (beta coefficient) of PD change stratified by weight change tertile and baseline BMI. Covariates included baseline PD, education, age and smoking.

Results: Among normal weight or overweight men, those with the largest body weight gain (>0.19 kg/year or ~>15 lb. total) had consistently more PD than men in the lowest tertile. Similar patterns were observed for changes in BMI and WC but not UAFA.

Baseline BMI status	Weight change (kg/yr) tertile	Cumulative #teeth with PD (mean±se)		Beta±se (#teeth with incident PD/3yrs)
		1968-1973	1993-1998
Normal (18.5-24.9kg/m2)	<=-0.05	3.6±0.4	12.6±0.8c	1.24 (0.14)
	>-0.05–0.19	3.9±0.3	13.3±0.7	1.52 (0.23)
	>0.19	4.3±0.8	14.1±0.6c	1.40 (0.16)
Overweight (25-29.9kg/m2)	<=-0.05	3.6±0.4	12.0±0.6d	1.02 (0.15)e
	>-0.05–0.19	3.9±0.4	13.4±0.6	1.45 (0.15)
	>0.19	4.3±1.2	15.2±0.6d	1.61 (0.16)e
Obese (≥30kg/m2)	<=-0.05	2.8±0.4ab	14.0±1.5	1.72 (0.44)
	>-0.05–0.19	4.2±0.3a	11.9±2.2	1.31 (0.19)
	>0.19	4.4±0.4b	12.9±1.3	1.27 (0.42)

^a-e Means and coefficients with matching superscripts differ, p<0.05.

Conclusions:

Normal weight and overweight men with large weight gains have higher levels of periodontal disease than men who maintained their weight over 30 years.