Obesity is a medical condition which involves accumulation of body fat, creating an adverse effect on a person’s health. It is a complex disorder and a multi-factorial disease that is now growing into a major health concern all over the world.
The factors that contribute in making a person obese includes:
- Imbalance between the energy consumed and energy burned
- Genetic
- Environmental
- Psychosocial
- Poor nutrition and eating habits
Many doctors consider obesity a chronic disease, and it has increased drastically in the younger generation of Pakistan.
According to researches carried out by different researchers have revealed that obesity increases the risk of:
- Type 2 diabetes
- Arthritis
- CVD
- Respiratory problems
- Breast, colon, endometrial and prostate cancer
Recent study has revealed that obesity has been found to contribute to periodontal disease, with insulin resistance creating a strong relationship between the two. People with higher levels of Body Mass Indices (BMI) produce high levels of inflammatory proteins.
Thus dentists need understand the association between obesity and periodontal disease and address this issue to the patients who are obese. Patients must be encouraged during their dental appointment to daily exercise and consume a healthy diet. They must be educated on the risks obesity possess on the overall health of a person, playing an active role in the development of cancer, CVD and diabetes.
During a dental visit, a complete medical history of the patient must be taken, with any medical issues that might lead to obesity to be noted and the patient must then be referred to his/her physician. Also the oral health status of a patient must be assessed and treatment must be prescribed on that basis. Dentists need to lay emphasis on the lessening or complete removal of plaque and accompanying inflammation, both supragingivally and subgingivally. Importance of home care must be explained, with patients being encouraged to brush twice a day and floss regularly with a dentifrice as it provides antibacterial protection and anti-inflammatory benefits.
Dentists are being approached to collaborate with the health care teams and create awareness among people together about how obesity interferes with dental practices. These repercussions include the following aspects:
- Developmental of periodontal disease and caries
Obese people diagnosed with periodontal disease have been found that their disease is not only caused by diabetes but by the secretion of adipose tissue via chemically inflammatory mediators, which can alter the response of periodontal tissues to the oral environment. Dentists must have knowledge of the causes and how to treat this problem.
- Practical considerations
A lot of dental procedures require the numbness of the alveolar nerve block and thus anesthesia is given at that place. It can be harder in obese patients to identify the landmarks through excess of soft tissue for injecting this type of injection, but a ‘lax’ tongue retractor can be helpful. Furthermore, it may be difficult to palpate cervical lymph in people having large neck.
Moreover, weight screening at dental cares can promote healthy atmosphere to reduce weight and improve oral health status and lowering the risk of oral and systematic health. Dentists must take into consideration the fact that obese children may have higher risk of dental erosion but not necessarily have higher risk of dental caries as compared to normal weight children.
- Conscious sedation
If an obese patient needs to be treated under conscious sedation, dentists must consider the difficulties in airway management and intravenous cannulation. The most suitable is to provide inhalation sedation with nitrous oxide during which oxygen levels must be kept at 30% or more.
