Obesity and Dental Caries: A State-of-the-Art Review of Shared Risk Factors, Biological Mechanisms and Current Evidence.

Inês Amaro, Anabela Paula, Ana Coelho, Carlos Miguel Marto, Mafalda Laranjo, Susana Alarico, Dírcea Rodrigues, Bárbara Oliveiros, Eunice Carrilho

Journal: Medical sciences (Basel, Switzerland) 2026;14(3):

PMID: 42506305

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Abstract

Obesity and dental caries are highly prevalent chronic conditions with significant global health impact. Although an association between these diseases has been suggested, the nature of this relationship remains unclear. This state-of-the-art review aims to synthesize current evidence on the interplay between obesity and dental caries, focusing on shared risk factors, salivary alterations and underlying biological mechanisms. Evidence indicates that obesity and dental caries share common behavioral and socioeconomic determinants, namely unhealthy dietary patterns with high intake of free sugars, poor oral hygiene habits and social disadvantage. Salivary alterations observed in obesity may also create a more cariogenic oral environment. Additionally, inflammatory mediators, oxidative stress markers and changes in the oral microbiome suggest biologically plausible links between both conditions. However, current data does not support a direct causal relationship, but rather a complex multifactorial interaction between obesity and dental caries driven by shared risk factors and modifiable behaviors. Preventive strategies should adopt an integrated approach targeting shared determinants, particularly diet, oral hygiene habits and socioeconomic status. Nevertheless, the predominance of cross-sectional evidence limits causal inference, highlighting the need for longitudinal studies that simultaneously assess obesity and dental caries, and that address salivary biomarkers using standardized methodologies across different age groups to clarify underlying mechanisms and assess their clinical relevance.

Address: Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.; Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.; Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal.; Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504 Coimbra, Portugal.; Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), Department of Mechanical Engineering, University of Coimbra, 3030-788 Coimbra, Portugal.; Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.; Laboratory for Evidence-Based Sciences and Precision Dentistry, University of Coimbra, 3000-075 Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.; Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal.; Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504 Coimbra, Portugal.; Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), Advanced Production and Intelligent Systems (ARISE), Department of Mechanical Engineering, University of Coimbra, 3030-788 Coimbra, Portugal.; Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.; Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal.; Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504 Coimbra, Portugal.; Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504 Coimbra, Portugal.; Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504 Coimbra, Portugal.; Department of Endocrinology, Diabetes and Metabolism, Unidade Local de Saúde de Coimbra (ULS Coimbra), 3004-561 Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.; Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal.; Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-504 Coimbra, Portugal.; Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.

DOI: 10.3390/medsci14030336

MeSH Terms: Humans, Dental Caries, Risk Factors, Obesity, Oral Hygiene, Biomarkers