Obesity Surgery Linked to Increased Dental Caries Risk

Study at University of Gothenburg Reveals Impact of Surgical Obesity Treatment on Oral Health

A recent thesis at the University of Gothenburg sheds light on a concerning issue related to surgical obesity treatment. According to the study, individuals who have undergone such surgical procedures may face a higher risk of dental caries and a general decline in oral health compared to their pre-surgery condition.

The primary objective of the thesis was to investigate the oral health of individuals both before and after receiving treatment for severe obesity. Participants in the study exhibited a body mass index (BMI) of 40 or higher, or 35 or more in combination with other medical conditions, such as diabetes. The treatments administered included surgical interventions as well as medical approaches.

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Medical treatment encompasses lifestyle advice, dietary management, potential drug therapy, and support for increased physical activity. However, surgery has proven to be more effective in terms of weight loss, and given the rising prevalence of obesity worldwide, an increasing number of individuals are opting for surgical solutions.

Negin Taghat, who conducted the research and serves as a dentist for the Swedish Public Dental Service in Region Västra Götaland, highlighted the importance of the study, saying, “Around 5,000 cases of obesity surgery are performed each year in Sweden alone, and the trend is increasing. We were therefore interested in seeing whether there is any change in the oral health of these patients after surgery.”

Elevated Caries Risk Post-Surgery

The study tracked 118 obese individuals and uncovered a clear correlation between higher BMI values and an increased risk of dental caries, with the risk escalating in line with rising BMI. Individuals with the highest BMI values faced double the risk of caries, and they were less likely to receive regular dental care.

After a two-year follow-up, the study demonstrated a notable divergence between the surgical and medical treatment groups. Those who had undergone surgery experienced a rise in caries lesions on the surface of tooth enamel, with their average increasing from 15.0 to 19.1. Conversely, individuals who received medical treatment witnessed a reduction in enamel lesions.

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Another significant finding pertained to deeper caries lesions in the dentine, where the average pre-treatment value stood at 4.3 lesions. Following two years of treatment, individuals in the surgery group displayed an average of 6.4 such lesions, while those in the medical treatment group had 4.9. Importantly, these associations remained statistically significant even when accounting for factors like socioeconomic status and other medical conditions.

Implications for Healthcare Professionals

Individuals who underwent surgical obesity treatment also reported a range of oral symptoms and a negative impact on their oral quality of life. Negin Taghat emphasized, “We saw that almost half of individuals experienced poorer oral health, with symptoms such as hypersensitive teeth and difficulties with chewing. The situation as a whole can also cause social discomfort.”

Given that healthcare and dental professionals frequently encounter these patient groups in their daily practice, the study underscores the need for awareness that oral health can be influenced by both obesity and obesity treatment. This knowledge is vital for planning preventive measures and providing comprehensive care.

The research group involved in this study is part of the larger BAriatic surgery SUbstitution and Nutrition (BASUN) initiative, which was initiated by researchers at the Sahlgrenska Academy to examine the long-term outcomes of medical and surgical obesity treatments. These findings offer valuable insights into the intersection of oral health and obesity, emphasising the need for a holistic approach to patient care.