Asking about if obesity is hereditary? Then, genes aren’t the most worrisome risk of obesity. An individual’s upbringing can be, the way the family raises, the daily food intake, importance placed on physical activity and how a person would take their behaviour model, are the bigger influences on likelihood of obesity than genes. Health is not valued till sickness comes, true isn’t? Obesity is not because it runs in the family!! It is because no one runs in the family!!!

Today, more than 95% of all chronic diseases is caused by food choice. Yes,being overweight is linked to a number of health and oral health diseases, including: heart disease, high blood pressure, diabetes, cancer, gallbladder and gallstones, breathing problems, such as sleep apnea (when a person stops breathing for a short time during sleep) and asthma, oral health problems such as caries, halitosis, poor oral hygiene, periodontal disease. Symptoms for obesity include breathlessness, Increased sweating, snoring, inability to cope with sudden physical activity, feeling tired, back and joint pain, low confidence and self-esteem, and feeling isolated.

Also Read: Exclusive interview with Minister Dr Harsh Vardhan

After being aware of the risks, proper health and oral hygiene should be maintained. And why is maintaining diet an important factor? Because a poor diet may result in lack of essential nutrients and vitamins thus potentially making it more difficult for your body to fight off an infection. A diet high in fat and calories, including large quantities of processed foods or sugar, and lack of physicalactivity, leads to obesity. Those same foods can cause oral health problems including gum disease, premature tooth loss and bad breath Our body craves for what is in our bloodstream. Wheat, sugar, alcohol, coffee and de-vitalized foods are designed to be addictive. Sugar being addictive – agreed. But how does sugar affect an individual’s health and oral health? Well, consuming sugar is bad for an individual, but consuming too much has become a norm and that can cause health issues. The only type of sugar the body needs is glucose, which it can make by breaking down carbohydrates, proteins and fats. When ingested, simple sugars are converted into plaque if not removed immediately. As plaque begins to accumulate on our teeth and gums, the risk of varying forms of gum diseases such a gingivitis and periodontitis, as well as tooth decay, may become inevitable.

In 2018, a study revealed that 170 children and young people have rotten teeth removed every day, undergoing general anaesthesia. That’s an unpleasant operation that is completely avoidable; we have got a lot of evidence to show that the main cause is excessive sugar. There are also links with type 2 diabetes, usually chronic disease seen in adults, but we are seeing more and more under the age of 25 these days.

Also Read: A Right Gesture Saves Life

So, what an oral health care professional should be aware of? Dentists must be aware of how nutrition impacts general and oral health, and how dental treatment can impact patient’s nutritional status. Oral health is strongly influenced by the daily intake of food; on the other hand, oral health can also play a significant role in nutritional intake and general health status. The dental caries is also a chronic disease and may be depend on oral hygiene, high intake of sugar added to food, lifestyle factor, and host factors (salivary flow, buffer capacity and buccal microflora). Relationship between obesity and gum disease – we actually don’t know if this is a one-way or a two-way street. For example, conditions like diabetes, the relationship is bilateral. Periodontal disease will affect diabetes and diabetes will worsen periodontal disease, so that could be a possibility here. What are the other reasons of obesity affecting gums and what would be its risk factors? Because of various dietary habits and improper maintenance of oral hygiene, chronic periodontal infection is an inflammatory state that is described by a deviation in microbial environment and composition of subgingival plaque bio films and accelerated destruction of tooth supporting structures. Thus, low glycaemic diet may be beneficial to our oral health. Periodontal diseases are also influenced by various risk factors including aging, smoking, oral hygiene, socio-economic status, psycho social stress, osteopenia, osteoporosis and various systemic diseases, which signifies that periodontitis does not merely occur as a consequence of plaque deposition but is also coupled with various other host factors. Also, on examination, obese adolescents exhibited multiple carious teeth, higher plaque index, gingival inflammation, bleeding on probing and probing depth compared to normal weight subjects of similar age.

Also Read: Minds of Medalists behind their Medals

An obese patient, whose lungs are often not large enough to lift heavy chest walls, can have trouble during breathing, especially when active. Also, during sleep the person might breathe through his/her mouth instead of nose, thus jaw is forced into an unnatural position for a longer period of time. This can lead to teeth grinding and development of an overbite, over jet or spacing between the anterior teeth.How can we, as dentists, help the obese patients? Dentists should include the evaluation of BMI in routine patient examination and eventually refer obese periodontal adolescents for weight reduction interventions like diet therapy, behavioural therapy, pharmacotherapy, so that they can have better control over periodontal inflammation.What are the practical considerations in dentistry? It can be difficult carrying out dental care for an obese patient: the maximum lifting weight for modern dental chair is approximately 140kg (23 stones). The position of anatomical landmarks may be less obvious if surrounded by fatty tissue, the landmarks for placement of an inferior alveolar nerve block can be impossible to palpate through excess soft tissue. It may be impossible to palpate cervical lymph nodes in a large neck. Also due to constant secretion of saliva, the mouth and teeth are rinsed and kept free off food debris and foreign particles, thus excess of buccal pad of fat hinders with self-cleansing action in the mouth. Because of lack of saliva present in the mouth, it can lead to dry mouth. Sip water frequently throughout the day and use alcohol-free antiseptic mouthwash daily for cure. A normal sized mirror is unsafe for retraction of soft tissues: a ‘lax’ tongue retractor can be useful.What is the alternative to conventional dental chair? Refer the patient to the hospital environment where the patient may be treated on an operating table or trolley. Another possible solution for obese patients is a custom-made chair such as DIACO dental chair. What is the difficulty faced during conscious sedation? When thinking about conscious sedation for obese patients, the potential difficulties in airway management and intravenous cannulation should be considered. The provision of inhalation sedation with nitrous oxide during which oxygen levels are maintained at or above 30% may be more appropriate. If intravenous sedation with midazolam is proposed, the overall benefit to the patient must be carefully weighed up against the increased likelihood of significant respiratory depression and the difficulties in managing a respiratory complication. New research suggests that the health of your mouth mirrors the condition of your body as a whole. A healthy smile can surely transform our visual appearance and the positivity of our mind-set.

‘Eat every two hours, sleep eight hours, have plenty of water and pray to keep calm. Most importantly, carry a smile on your face.’

About the author

Dr. Vishaj S. Maru is a dental surgeon. She studied dentistry at the D.Y. Patil School of Dentistry. She does clinical practice in Mumbai with a keen interest in academia and clinical dentistry.

Complete Blood Count

A complete blood count is a blood test which helps to evaluate the overall health and helps in detecting a wide range of diseases and disorders including anaemia, various infections and even life-threatening diseases such as leukaemia. This is not an age-specific test. The doctors suggest each woman undergo the test and get their complete blood count twice in a month.

Screening of Diabetes

If in the early stages, diabetes doesn’t show any symptoms but when in later stages it can severely affect the kidney, liver and even eyes of the patient. The basic diabetes check-ups include fasting plasma glucose and pre-prandial plasma. The A1C test provides three -month report of the blood glucose levels. Diabetes screening should be done annually if the reports are normal.

Mammogram Test (Breast Cancer Screening)

A mammogram, which screens breast cancer, involves compressing the breast between the X-ray plates so that the images can be captured. The chances of breast cancer increase with an increase in age. Doctors suggest that women should undergo annual screenings from the age of 45 and recommend mammogram twice a year. In case of family history of the disease, one must consult the doctor at the earliest and he/she may suggest for frequent mammograms.

Thyroid (TSH), T3 and T4

Thyroid function tests are a series of blood tests which measure the normal functioning of the thyroid gland. Disorder of thyroid can affect women of all age causing disturbance in normal puberty and menstruation cycles. An overactive or under-active thyroid gland may also affect the ovulation leading to infertility in women. It is essential for women to get their thyroid tested regularly each year or as per the doctor’s recommendation.

Lipid Profile

High Cholesterol level not only increases your chances of cardiovascular diseases, stroke but also links you to the gall bladder disease. In women, the screening must start from the age of 20. At the age of 45 and/or a family history of heart disease, one must undergo the annual screening.

Cervical Cancer Screening or Pap Smear

Cervical cancer arises from the cervix. It is due to the abnormal growth of cells that can grow to other major parts of the body. HPV or Pap test helps to detect the growth of these abnormal cells which may become cancerous in the future. Women within the age of 21–65 years must undergo the screening once in three or a maximum of five years.

Bone Mineral Density (BMD) or Osteoporosis

This test measures how much calcium and other types of minerals your bones contain. It helps in detecting osteoporosis and predicts the risk of bone fractures. The most common way to perform this test is DEXA which are low-dose X-rays. Women aging between 20–29 years must get tested once in two months.

About the author

CA (Dr.) Ruchi Gupta is the Founder of 3Hcare – a synonym to quality healthcare services in Delhi NCR – with the objective to provide quality diagnostic related services at affordable prices. She is a prolific educationist, qualified UGC NET- JRF, having a decade long experience in mentoring management students in the field of applied Finance & Business Management.