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Higher risk of dental issues after bariatric surgery

Bariatric patients have a higher risk of decaying and crumbling teeth (dental caries) than before surgery and often experience a general decline in oral health, according to the outcomes from a doctoral thesis from the University of Gothenburg.

"Around 5,000 cases of obesity surgery are performed each year in Sweden alone, and the trend is increasing," explained Negin Taghat, who has defended her doctoral thesis at the Institute of Odontology at the University of Gothenburg's Sahlgrenska Academy, and who works as a dentist for the Swedish Public Dental Service in Region Västra Götaland. "We were therefore interested in seeing whether there is any change in the oral health of these patients after surgery."


The aim of the research was to study the oral health of individuals before and after treatment for severe obesity. The participants had a BMI>40 or 35 or more in combination with co-morbidities. Treatment involved either bariatric surgery or medical treatment (lifestyle advice, dietary treatment, possible drug treatment, and support with increased physical activity).


In total, 118 individuals with obesity were included in the study, which found those with a higher BMI were associated with higher caries risk according to a rising scale. At the highest BMI values, there was a doubled risk of caries and less regular dental care.

Two years after either surgical or medical treatment, a clear division emerged between the groups. Those who had undergone surgery had gone from an average of 15.0 caries lesions on the surface of the tooth enamel to 19.1. Within the group receiving medical treatment, however, enamel lesions had decreased.


Another example relates to deeper caries lesions in the dentine, with an average pre-treatment initial value of 4.3 lesions. Two years after treatment, individuals in the surgery group had an average of 6.4 such lesions while those in the medical treatment group had 4.9. The associations were statistically significant, even when taking factors such as socioeconomic status and other medical conditions into account.


"Individuals who have undergone surgical obesity treatment may also experience a variety of oral symptoms and an impact on their oral quality of life," added Negin. "We saw that almost half of individuals experienced poorer oral health. Health professionals and dental professionals meet these patient groups in their everyday work. It is extremely important for staff to be aware that oral health can be affected by both obesity and obesity treatment so that preventive measures can be planned."


Symptoms can include hypersensitive teeth and difficulties with chewing. The situation as a whole can also cause social discomfort.


The group investigated within the thesis is part of the larger BAriatic surgery SUbstitution and Nutrition (BASUN) study, initiated by researchers at Sahlgrenska Academy to compare long-term outcomes of medical and surgical obesity treatment.

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