When treating children, dental professionals frequently encounter preventable oral health problems that can lead to severe consequences. Tooth decay fuelled by excessive sugar consumption is currently the leading cause of paediatric hospital admissions.[i] However, the influence of high sugar, high-fat diets doesn’t stop with decay. For example, evidence shows that inflammation associated with obesity is linked to periodontitis and edentulism.[ii]
Dental professionals are accustomed to advising children and their parents on dietary habits that can impact on oral health. Where children are living with obesity, clinicians may also have an opportunity to intervene to support families in improving their lifelong oral health outcomes, as well as to reduce the risk of associated systemic health challenges.
The scope of the problem
In 2022-23 21.3% of 4 to 5-year-olds and 36.6% of 10 to 11-year-olds were found to be overweight. 15% of children between the ages of 2 and 15, and 19% of children aged between 11 and 15 were classed as obese.[iii]
Obesity increases the risk of type 2 diabetes, heart disease, stroke, cancer, mental ill health and other health conditions and illnesses affecting patients’ quality of life, and potentially shortening their lifespan.iii When an individual becomes overweight, their risk of death increases by 20–40%, escalating to 200–400% when entering the obesity category. Every year, obesity is thought to cause the deaths of around 3.4 million people.ii
A diet high in sugars and processed foods associated with obesity contributes to a higher incidence of dental caries among overweight children, but obesity also affects other processes within the body associated with oral health issues. For example, as well as contributing to inflammation, the production of saliva is impaired in obese patients, reducing its important flushing, antibacterial and remineralising properties.ii
Obesity is also associated with obstructive sleep apnoea (OSA) and other breathing problems. As well as being a systemic health concern, OSA is linked with xerostomia, dental caries, bruxism, and occlusal problems – especially in developing jaws.[iv] A bi-directional relationship between OSA and temporomandibular joint (TMJ) disorders, orofacial pain and bruxism has also been identified.[v]
What is obesity?
Obesity is usually diagnosed using body mass index (BMI) calculations, which are achieved by dividing a patient’s body weight in kilograms by height in meters squared. While not as accurate in predicting health risks as imaging technology such as computed tomography (CT) and magnetic resonance imaging (MRI), BMI can, in most cases, quickly provide relevant information.[vi]
A healthy weight is generally represented by a BMI between 18.5 and 24.9 kg/m2. An individual is classed as overweight with a BMI between 25 and 29.9kg/m2, and obese with a BMI of 30 kg/m2 or more. A BMI of over 40 kg/m2 represents severe obesity. Risks to health occur at lower BMI thresholds for people with South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean backgrounds. These are calculated by reducing the obesity threshold above by 2.5 kg/m2.[vii]
Addressing childhood obesity in the dental surgery
The Making Every Contact Count (MECC) approach, launched by the NHS in 2016, encourages all healthcare professionals, whatever their role, to use opportunities during their interactions with patients to encourage positive improvements to their health or wellbeing.[viii] While not all dental practices conduct routine weight screening, a recent survey[ix] suggested that 60% of patients support the idea. 67% of parents and carers are in favour of receiving support with weight loss for their children from the dental team.
While discussing the importance of oral hygiene, clinicians can educate children and their parents and carers on the risks associated with unhealthy dietary habits. Children’s oral hygiene routines at home can be enhanced with the use of tools like CLASSIC 03 BABY, 04 KIDS and 09 JUNIOR toothbrushes for children from TANDEX. These soft brushes are kind to children’s developing gingivae and enamel, and are specifically designed to help parents and carers teach children how to take special care of their teeth and gingivae.
Where children are consuming excess amounts of sugar or processed foods, to prevent the onset of complications such as decay and periodontal disease and those related to obesity, it is important to provide families with honest and accurate information about potential risks to their health. Doing so can do much to improve the lifelong wellbeing of young patients.
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Our products are also available from DHB Oral Healthcare https://dhb.co.uk/
Author: Jacob Watwood
[i] Dental Surgeons: Too many children admitted to hospital for tooth decay. Royal College of Surgeons of England. September 2024. Available at: https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/fds-dental-admissions-sept-24/ Accessed April 2025
[ii] Issrani R, Reddy J, Bader AK, Albalawi RFH, Alserhani EDM, Alruwaili DSR, Alanazi GRA, Alruwaili NSR, Sghaireen MG, Rao K. Exploring an Association between Body Mass Index and Oral Health-A Scoping Review. Diagnostics (Basel). 2023 Feb 27;13(5):902. doi: 10.3390/diagnostics13050902. PMID: 36900046; PMCID: PMC10000970.
[iii] One in eight toddlers and primary school aged children obese NHS England. Press release. September 2024. Available at: https://www.england.nhs.uk/2024/09/one-in-eight-toddlers-and-primary-school-aged-children-obese/ Accessed April 2025
[iv] Berggren K, Broström A, Firestone A, Wright B, Josefsson E, Lindmark U. Oral health problems linked to obstructive sleep apnea are not always recognized within dental care-As described by dental professionals. Clin Exp Dent Res. 2022 Feb;8(1):84-95. doi: 10.1002/cre2.517. Epub 2021 Nov 17. PMID: 34791818; PMCID: PMC8874038.
[v] Ning, R., Chen, J., Lu, Y. et al. Obstructive sleep apnea: a follow-up program in its relation to temporomandibular joint disorder, sleep bruxism and orofacial pain. BMC Oral Health 23, 578 (2023). https://doi.org/10.1186/s12903-023-03264-9
[vi] Purnell JQ. Definitions, Classification, and Epidemiology of Obesity. [Updated 2023 May 4]. In: Feingold KR, Ahmed SF, Anawalt B, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279167/
[vii] Obesity: What is it? National Institute for Health and Care Excellence (NICE) February 2025. Abailable at: https://cks.nice.org.uk/topics/obesity/background-information/definition/ Accessed April 2025
[viii] Making every contact count (MECC). NHS. ND. Available at: https://www.hee.nhs.uk/our-work/population-health/our-resources-hub/making-every-contact-count-mecc Accessed April 2025
[ix] Dental teams help people manage their weight. NIHR. November 2024. Available at: https://bepartofresearch.nihr.ac.uk/news-and-features/dental-survey Accessed April 2025
