ABSTRACT
BACKGROUND: Patients undergoing bariatric surgery often complain of bad breath. However, the relationship between bariatric surgery and halitosis is relatively unknown. The purpose of the present study was to evaluate and compare the occurrence of halitosis among patients before and after a specific type of bariatric surgery, Roux-en-Y gastric bypass, and its relationship with the tongue coating index, plaque index, and salivary flow rate. METHODS: A total of 62 patients with good oral health and in treatment for obesity at the walk-in clinic of Santa Casa Hospital, Belo Horizonte, Brazil, were selected. Of this sample, 31 were bariatric surgery candidates (control group) and 31 had already undergone Roux-en-Y gastric bypass surgery (case group). After completing a questionnaire, all patients underwent an oral clinical examination. Halitosis was measured using an organoleptic scale and a portable sulfide monitor. RESULTS: The Spearman correlation demonstrated a strong positive relation between the organoleptic rates and the concentration of volatile sulfur compounds determined using the sulfide monitor (rs = .58; P = .0001). No difference was found in the prevalence of halitosis between the 2 groups (P = .48). Only the salivary flow rate was significantly reduced in the control group compared with the case group (P = .02). In the case group, the concentration of volatile sulfur compounds correlated negatively with the salivary flow rate (P = .04) and positively with the tongue coating index (P = .005). The tongue coating index was significantly increased in those patients who did not brush the tongue (P < .04) and who had had episodes of vomiting (P = .02). CONCLUSION: These data suggest that no significant association exists between halitosis and Roux-en-Y gastric bypass. However, they do highlight the possible effect of this surgery on the oral cavity.
Subject(s)
Gastric Bypass , Halitosis/etiology , Obesity/surgery , Adolescent , Adult , Aged , Case-Control Studies , Dental Plaque/etiology , Dental Plaque/metabolism , Dental Plaque Index , Female , Halitosis/metabolism , Humans , Male , Middle Aged , Obesity/complications , Postoperative Care , Preoperative Care , Saliva/physiology , Sensation/physiology , Sulfur Compounds/analysis , Tongue/chemistry , Young AdultABSTRACT
BACKGROUND: Recent studies have shown that being overweight or obese is associated with a higher risk of periodontitis. However, the literature offers an insufficient number of published reports regarding the effect of bariatric surgery on oral health. As such, the present study aims to determine the association between periodontal status and being overweight/obese in prebariatric and postbariatric surgery populations of Brazil. METHODS: Three hundred forty-five participants between 18 and 60 years of age, from both sexes, were grouped according to prebariatric or postbariatric surgery and underwent a complete periodontal examination. Biologic, demographic, and behavioral variables were analyzed in a Poisson regression model. RESULTS: Considering the timing of bariatric surgery, the sample was divided into three groups: PRE-OP (preoperative, n = 133), POS-OP1 (postoperative ≤6 months, n = 72), and POS-OP2 (post-surgery >6 months, n = 140). Regardless of the type of surgery (PRE-OP, POS-OP1, POS-OP2), the prevalence of periodontitis proved to be high (81.45%). There was a statistically significant difference in the prevalence of periodontitis among the PRE-OP, POS-OP1, and POS-OP2 groups (P = 0.040). In the Poisson regression model, after adjusting for biologic, demographic, and behavioral risk variables, only bleeding on probing remained significantly associated with the prevalence of periodontitis (P <0.001). CONCLUSION: Differences in periodontal condition were observed in individuals at different times of the bariatric surgery, showing a high prevalence of periodontitis in both preoperative and postoperative follow-up.
