European Journal of Cardiovascular Medicine

There is growing global interest in the relationship between body fat percentage and the incidence of dental caries, with both conditions regarded as significant public health concerns. Dental caries continues to be one of the most prevalent chronic diseases in both children and adults, and is influenced by a complex interplay of biological, behavioral, and environmental factors. Simultaneously, the prevalence of obesity and increased body fat is rising, linked to shifts in dietary habits, physical inactivity, and socioeconomic changes.[1-5]

Recent studies have explored how body composition, specifically body fat percentage, might be associated with dental caries incidence. The mechanisms underlying this relationship are multifactorial, involving nutritional status, dietary patterns, and metabolic health. Common risk factors such as excessive intake of sugar-rich, processed foods and sedentary lifestyles contribute to both obesity and dental caries. A significant association between body fat and caries experience has been demonstrated, with multivariate analysis indicating a direct correlation. Notably, body composition variables such as bone mass, BMI, and body fat have shown statistically significant links to caries scores in children.[6,7]

The pathogenesis of dental caries is deeply intertwined with dietary factors. Diets rich in fermentable carbohydrates promote plaque formation and bacteria proliferation, thereby increasing caries risk. Conversely, diets high in fiber can decrease plaque accumulation, thus helping prevent tooth decay. It is important to note that malnutrition, whether due to undernutrition or overnutrition, can affect oral health differently. While some studies have reported a positive association between higher body fat or BMI levels and dental caries, others have found contrasting results or no significant relationship at all. For example, some evidence suggests overweight children may have a lower caries rate compared to their underweight or normal-weight peers, possibly due to differences in dietary quality and oral hygiene behaviors. However, most literature points toward an increased risk of caries as body fat or BMI rises, especially when accompanied by poor dietary habits and oral hygiene.[8,9,10]

Body fat percentage, typically assessed by bioelectrical impedance or anthropometric measures, provides a broader perspective on nutritional status compared to BMI alone. Incorporating body composition variables into oral health studies can yield more nuanced insights, revealing the indirect effects of systemic health on oral outcomes. For example, studies using DXA or advanced composition analysis demonstrate that higher body fat may be associated with poorer oral health-related quality of life and greater caries risk, especially in older adults and children.[11]

The bidirectional relationship between body fat and dental health warrants a multidisciplinary approach in both clinical and public health settings. Diet counseling, regular dental check-ups, healthy nutrition, and physical activity are recommended preventive measures. Addressing lifestyle factors linked to both obesity and dental caries could not only reduce the prevalence of each condition but also improve overall health. Awareness programs, informed parental guidance, and school-based interventions play crucial roles in this context.[12]

Despite promising findings, the correlation between body fat percentage and dental caries remains a topic of debate. Discrepancies across studies may be attributed to differences in study design, population demographics, measurement techniques, and confounding factors. Further longitudinal research is needed to clarify causality and explore underlying biological mechanisms. Ultimately, understanding how body composition affects dental caries can guide targeted prevention and health promotion strategies, especially in pediatric and adolescent populations where both obesity and dental caries are endemic.[13].

Study Design:

This was a cross-sectional study conducted to explore the relationship between body fat and dental health, measured by the DMFT (Decayed, Missing, and Filled Teeth) scores in a sample of patients.

Study Population:

The study included a total of 100 patients who were categorized into three body fat groups: low, normal, and high. Body fat was determined using standardized body composition methods (e.g., bioelectrical impedance analysis or skinfold thickness measurements).

Data Collection:

Data on body fat category were collected through clinical assessment, and the DMFT scores were obtained from dental examinations performed by trained professionals. The DMFT score was classified into three ranges: 0-2 (low dental decay), 3-5 (moderate decay), and 6+ (severe decay). Patients' dental records were also reviewed to gather additional details on decayed, missing, and filled teeth.

Inclusion Criteria:

Patients aged 18-65 years, with no history of systemic diseases affecting body fat distribution, were included in the study. Only individuals who had undergone a complete dental examination were considered.

Exclusion Criteria:

Patients with incomplete medical or dental records, those under medication affecting body fat or oral health (e.g., steroids), and individuals with conditions that could confound the results (e.g., diabetes) were excluded.

Statistical Analysis:

Descriptive statistics were used to summarize the body fat distribution and DMFT scores. A Chi-square test was conducted to assess the correlation between body fat category and DMFT scores. The mean DMFT scores and standard deviations were calculated for each body fat category. A significance level of p<0.05 was used to determine the statistical significance of the findings.

Ethical Considerations:

The study was approved by the institutional ethical review board, and informed consent was obtained from all participants prior to data collection.

Table 1: Patient Distribution by Body Fat Category

Table 1 shows the distribution of patients across different body fat categories. Among the total number of patients, 17 are classified as having low body fat, 43 have normal body fat, and 40 have high body fat.

Table 2: DMFT Score Range in Each Body Fat Category

Table 2 presents the distribution of patients' DMFT (Decayed, Missing, and Filled Teeth) scores within each body fat category. For low body fat, the majority of patients (11) have a DMFT score in the 0-2 range, while 6 patients fall within the 3-5 range, and none have a DMFT score above 6. In the normal body fat category, 28 patients have a DMFT score between 0-2, 14 patients have scores between 3-5, and 1 patient has a DMFT score above 6. For those with high body fat, the distribution is 7 patients in the 0-2 range, 19 patients in the 3-5 range, and 14 patients in the 6+ range, indicating a higher prevalence of poorer dental health in this group.

Table 3: Mean DMFT and Standard Deviation by Body Fat Category

Table 3 provides the mean DMFT scores and their standard deviations (SD) for each body fat category. The mean DMFT score for the low body fat group is 1.94 with an SD of 1.43, indicating a generally lower level of dental decay and treatment. For the normal body fat group, the mean DMFT score is 2.84 with an SD of 1.74, showing a moderate level of dental issues. However, the high body fat group exhibits the highest mean DMFT score of 5.20 with an SD of 2.66, suggesting a higher prevalence and more variability in dental decay and treatment.

Table 4: Percentage Distribution of DMFT >5

Table 4 highlights the percentage of patients with a DMFT score greater than 5 in each body fat category. For low body fat, none of the patients have a DMFT score greater than 5, while for the normal body fat category, only 2.3% of patients have a DMFT score above 5. In contrast, 35% of the patients in the high body fat group have a DMFT score greater than 5, indicating a significant association between higher body fat and worse dental health.

Table 5: Correlation between Body Fat Category and DMFT (Chi-square)

Table 5 presents the statistical analysis of the correlation between body fat category and DMFT using the Chi-square test. The Chi-square value is 19.65 with a p-value of 0.0002, which indicates a statistically significant relationship between body fat category and DMFT scores. This suggests that the distribution of DMFT scores varies significantly across different body fat categories.

In terms of dental health, individuals with low body fat generally exhibited better oral health, as most patients in this group had low DMFT scores, with none having severe dental issues. In contrast, the high body fat group showed a higher prevalence of dental decay, with a significant proportion of patients having moderate to severe DMFT scores. The mean DMFT scores further reflected these differences, with the high body fat group having the highest average score, suggesting more dental issues and greater variability in dental health within this group.
Additionally, the percentage of patients with a DMFT score greater than 5 was markedly higher in the high body fat group, with a considerable gap compared to both the low and normal body fat groups. This further suggests a strong link between increased body fat and poorer dental health outcomes.

The findings of the present study demonstrate a notable association between body fat levels and dental health, as measured by DMFT (Decayed, Missing, and Filled Teeth) scores. The analysis revealed that the normal body fat category comprised the largest proportion of participants, followed by individuals with high and low body fat. Individuals with low body fat typically showed better oral health outcomes, with the majority having low DMFT scores, and none presenting severe dental problems. Conversely, the high body fat group exhibited a greater prevalence of dental decay and a higher proportion of moderate to severe DMFT scores. The mean DMFT score was highest in the high body fat group, indicating more dental issues and greater variation within this subset. Notably, the percentage of patients with DMFT scores over 5 was significantly greater in the high body fat group, underscoring a strong relationship between increased body fat and poorer oral health. Statistical analysis confirmed a significant correlation between body fat levels and DMFT scores, supporting the conclusion that higher body fat is linked to worse dental health outcomes.Talluri et al[1] reported a positive correlation between dental caries status and BMI among school children, with higher BMI associated with increased DMFT scores. Akarsu et al[14] found similar trends in a Turkish adult population, demonstrating that the DMFT index was significantly higher in obese individuals compared to those with normal or overweight status; the difference remained significant across genders. Kızılcı et al[2] conducted research on children and observed that caries risk increased as body weight and BMI rose, with the obese group having the highest DMFT/dmft values, while normal and underweight groups generally had better oral health. Singh et al [15]highlighted a positive correlation between DMFT and overall oral health impairment, showing that increasing BMI is associated with poorer oral health scores. Awad et al[8] corroborated these findings in adolescents, demonstrating that obesity measured by waist circumference was significantly linked to increased dental caries risk.

 However, some studies offer different perspectives. Alswat et al[10] observed non-significant differences between overweight/obese and normal weight patients regarding DMFT scores, suggesting that while the trends are notable across populations, multifactorial influences such as oral hygiene habits, socioeconomic status, and diet quality play essential roles. Similarly, Kabbarah et al [16]emphasized that, after adjusting for confounding factors, obesity remained significantly associated with higher DMFT scores, but social determinants and behavior also modulated the relationship.

 Collectively, the literature supports a consistent pattern: individuals with higher body fat—especially those categorized as overweight or obese—are more likely to experience worse dental health, as evidenced by higher DMFT scores and a greater prevalence of moderate to severe dental decay. These findings align with the present study and underscore the value of targeted interventions focusing on both nutritional guidance and oral health education, particularly for populations at risk due to elevated body fat.

The study demonstrates a significant relationship between higher body fat and poorer dental health, as indicated by higher DMFT scores. Patients with high body fat had more severe dental decay and greater variability in dental health compared to those with low or normal body fat. These findings suggest the importance of addressing body fat management as part of overall dental care and health interventions. Further research could explore the underlying mechanisms driving this association.

1. Talluri D, et al. Correlation of dental caries status with BMI in school children. J Pediatric Res. 2023 Apr 16; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10259550/
2. Kızılcı E, et al. Is Body Mass Index for-age Related with Dental Caries in Children. J Pediatr Res. 2022 Mar 07; Available from: https://jpedres.org/articles/is-body-mass-index-for-age-related-with-dental-caries-in-children/jpr.galenos.2021.26023
3. Issrani R, et al. Exploring an Association between Body Mass Index and Oral Health. J Clin Diagn Res. 2023 Feb 26; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10000970/
4. Kapil D, et al. To Assess the Prevalence of Dental Caries and Its Correlation with Dietary Habits and BMI. J Oral Health Comm Dent. 2022 Dec 31; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10507296/
5. Singh S, et al. Impact of dental caries and nutritional status on oral health related quality of life. J Pediatric Res. 2023; Available from: https://www.sciencedirect.com/science/article/pii/S2212426823000544
6. Study to estimate prevalence of dental caries and determine its association with body composition amongst school-going children of Jodhpur city. Int J Med Health Sci. Available from: https://www.ijmrhs.com/medical-research/study-to-estimate-prevalence-of-dental-caries-and-determine-its-association-with-body-composition-amongst-school-going-c.pdf
7. Irigoyen-Camacho ME, et al. Physical Performance, Body Composition, and Oral Health-Related Quality of Life. Folia Medica. 2024 Jun 25; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11270300/
8. Awad M, et al. Association between obesity and dental caries among adolescents. Front Oral Health. 2023 Jun 26; Available from: https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2023.1160428/full
9. Kumar S, et al. Relationship between body mass index and dental caries. J Int Soc Prev Community Dent. 2020 Oct 27; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9376681/
10. Alshehri YFA, et al. Association between body mass index and dental caries in adults. Saudi J Oral Sci. 2020; Available from: https://www.sciencedirect.com/science/article/pii/S1013905219308806
11. Alswat K, et al. The Association Between Body Mass Index and Dental Caries. J Clin Med Res. 2015; Available from: https://www.jocmr.org/index.php/JOCMR/article/download/2433/1372
12. Shah MA, et al. Relationship between body mass index (BMI) and oral health status. J Indian Soc Periodontol. 2023; Available from: https://www.sciencedirect.com/science/article/pii/S2213398423001471
13. Correlation between Body Composition and Oral Health Status. Int J Clin Pediatr Dent. Available from: http://www.ijcpd.org/journal/view.html?uid=631&vmd=Full
14. Akarsu S et al. Association Between Body Mass Index and Dental Caries in Turkish Adults. 2020 Mar 31. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11654477/
15. Singh S et al. Impact of dental caries and nutritional status on oral health. 2023. Available from: https://www.sciencedirect.com/science/article/pii/S2212426823000544
16. Awad M et al. Association between obesity and dental caries among adolescents. 2023 Jun 26. Available from: https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2023.1160428/full