Морбідне ожиріння як медико-соціальна проблема та шляхи її вирішення

Abstract

In a review article summarizes the data of the scientific literature related to the problem of the correlation between the body mass index and pathological changes in the organs of the oral cavity. Today it has been proven that overweight and obesity are important risk factors for dental health of people of all ages. Obesity is a complex and multifactorial disease. His relationship to the health of the oral cavity is actively investigated by scientists. According to the World Health Organization, 1.9 billion adults, 18 years and older, are overweight. Of these over 600 million were obese. The body mass index (BMI) is used to quantify the fat depot in the body. Indicator of BMI from 18.5 to 24.9 is considered normal; from 25.0 to 29.9 reflects excess body weight, more than 30.0 indicates to obesity development. The aim of the study was to analyze a modern scientific literature on the correlation between BMI and the oral health. Metabolic disorders in the human body in the conditions of obesity are systemic causative factors of the development of periodontal diseases. According to epidemiological studies, toothless men and women have, on average, higher BMI and visceral obesity, compared to those who have teeth. The adverse effects of obesity on periodontium may be mediated by the action of such proinflammatory cytokines as interleukins (IL-1, IL-6 and TNF-α), adipokines (leptin, adiponectin, resistin and plasminogen activator inhibitor-1), and a number of other biologically active substances, such as reactive oxygen species, which can directly affect the periodontal tissues. Obesity increases the susceptibility to infectious agents by modulating the immune and inflammatory response, resulting in an increased risk of periodontitis. Obesity adversely affects the cell-mediated immune response and reduces the immune function of lymphocytes and the activity of natural killer T cells. In a number of clinical trials and meta-analyzes, it has been shown that patients with obesity have a more severe course of inflammatory periodontal disease. A number of authors in their studies emphasize that weight gain and obesity are one of the factors that lead to caries development, even in childhood. A number of studies have established a positive correlation between dental caries and BMI. It has been established that obesity leads to the development of hyposalivation in adults and children. However, the relationship between hyposalation and obesity is not sufficiently investigated. Some scientists have suggested that inflammatory mediators play an important role in hypofunction of salivary glands in obesity. The effects of prolonged hyposalivation are determined by the decreased physiological functions of saliva. Reduced secretion of saliva and changes in the composition of saliva cause development of pathological processes in the oral cavity and other parts of the gastrointestinal tract. Thus, the analysis of modern scientific literature suggests that the increase in the body mass index, regardless of other risk factors, leads to pathological changes in the organs of the oral cavity. Undoubtedly, the foregoing stipulates the need for a continuous expansion of research aimed at developing new approaches to prevent the development of dental diseases in people with excessive body weight and obesity