Does Non-Surgical Periodontal Therapy in Overweight and Obesity Result in a Change in Body Mass Index? A Review of Current Evidence.

Focused Clinical Question In patients with chronic periodontitis (CP) classified as overweight or obese who receive non-surgical periodontal therapy, is a change in body mass index (BMI) associated with periodontal treatment? Clinical Scenario A 47-year-old male presents to your office with a chief complaint of "I was told I have periodontal disease." He is missing tooth #9 and has significant supragingival and subgingival calculus deposits (Fig. 1). After examination, you assign a diagnosis of generalized moderate to severe CP. His probing depths (PDs) range from 2 to 8 mm, and his clinical attachment levels range from 2 to 8 mm, with 56% of sites demonstrating PD ≥4 mm. His medical history is significant for hypertension, osteoarthritis, gastroesophageal reflux disease, and obesity, with a current BMI of 31 kg/m2. He reports taking 5 mg enalapril every day, ibuprofen as needed for pain, and 20 mg omeprazole every day. Your treatment plan includes non-surgical therapy and periodontal reevaluation before possible phase II surgical treatment. The patient states that he recently read an article in lay media discussing the link between obesity and periodontal disease and is interested in optimizing his health.