Bidirectional association between obesity and chronic periodontitis: Inflammatory pathways and clinical implications

Abstract

Obesity and chronic periodontitis are the prevalent chronic conditions significantly linked through shared common inflammatory and immune mechanisms. This review aimed to synthesize current knowledge on the association between obesity and chronic periodontitis, exploring biological mechanisms, epidemiological evidence, and clinical relevance. Obesity induces systemic low-grade inflammation marked by elevated pro-inflammatory cytokines, altered immune responses, and disrupted adipokine profiles that may influence periodontal inflammation. Conversely, chronic periodontitis, characterized by oral microbial dysbiosis and local inflammation, contributes to systemic inflammatory burden and potentially exacerbates obesity-related complications. Obesity-associated dietary habits further promote pathogenic oral microbiome shifts as well as aggravate periodontal inflammation. Clinically, obese patients frequently exhibit more severe chronic periodontitis and diminished responsiveness to conventional periodontal therapies, highlighting the need for tailored clinical interventions and integrated healthcare approaches. Public health efforts should make dental care easier to access, support teamwork between health professionals, and offer clear education to help manage both obesity and chronic periodontitis. Although researches have advanced significantly, the exact causal mechanisms still remain unclear. Further studies are needed to improve prevention as well as treatment strategies, ultimately reducing the global burden of obesity and chronic periodontitis.