Structural Relationships between Asthma and Dental Caries in Children: A Birth Cohort Study in Southern Brazil.

INTRODUCTION: There is an inconclusive causal association between asthma symptoms and dental caries in the primary dentition. This study aimed to investigate, using SEM (structural equation modeling), a possible causal relation between asthma and dental caries in the primary dentition. METHODS: Using data from the 2004 Pelotas Birth Cohort Study, a sub-sample of 1,303 individuals was selected. Dental caries was clinically evaluated at 5 years old based on decayed, missing, and filled tooth (dmft) index criteria. Asthma-related symptoms (wheezing and shortness of breath) at 1- and 4-year-olds composed a latent variable and were the main exposures to caries occurrence. SEM was used to identify possible direct, indirect, and mediated effects of asthma in primary dentition dental caries. RESULTS: The general prevalence of caries at age 5 was 1.95 (SD: 3.56). When comparing the dmft values for children with asthma symptoms and those without, they presented similar values in both periods where asthma symptoms were evaluated (1- and 4-year-old). SEM analysis showed that asthma was neither directly nor indirectly related to dental caries. CONCLUSION: Asthma, using a latent variable constructed based on asthma symptoms, showed no causal effect on dental caries occurrence in the primary dentition.

Depression and anxiety among the University community during the Covid-19 pandemic: a study in Southern Brazil.

This study aimed to assess the mental health of a University community in South Brazil during the COVID-19 pandemic. A cross-sectional web-based survey was conducted between July-August 2020 through a self-administered questionnaire. All University staff and students were eligible. Depression was measured using the Patient Health Questionnaire-9 and anxiety by the Generalized Anxiety Disorder-7. To evaluate the effect of social distancing and mental health factors on outcomes, Poisson regression models with robust variance were performed, estimating Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI). 2,785 individuals participated in the study. Prevalence of depression and anxiety were 39.2% (95%CI 37.3-41.1) and 52.5% (95% CI 50.6-54.4), respectively. Undergraduate students showed a higher prevalence of the outcomes. Not leaving the house routinely, mental health care, and previous diagnosis of mental illness were associated with both outcomes. Those with a previous medical diagnosis of depression had a 58% (PR 1.58; 95%CI 1.44; 1.74) and anxiety a 72% (PR 1.72; 95%CI 1.56; 1.91) greater prevalence of depression than their peers. An alarming prevalence of psychopathologies was observed. Despite the well-known benefits of social distancing to public health, it requires a surveillance on the population's mental health, especially students and those with previous mental illness diagnosis.

Validity of self-reported oral conditions among Brazilian older women: Do socio-economic factors matter?

OBJECTIVE: To validate the level of agreement between self-report and clinical examination for oral conditions and evaluate the effect of sociodemographic conditions on the validity of self-report among women aged 60 and older. METHODS: A cross-sectional study was conducted in a social community center for seniors in Southern Brazil. Sociodemographic data (age, level of education, and income) were measured. Participants were interviewed and clinically examined for the number of teeth (DMF-T index) and the use of dental prostheses. The self-reported number of teeth in each arch and the use of dental prostheses were gathered through interviews. The level of agreement was estimated using the observed agreement, Kappa statistics, sensitivity/specificity (edentulism/prostheses) and Lin's concordance correlation coefficient, and related tests (number of teeth). The validity of the oral conditions was estimated according to sociodemographic information. RESULTS: Ninety-nine women participated in the study. High levels of agreement were observed for edentulism (97.8%; 95%CI 92.8;99.7; Kappa 0.947) and the use of dental prostheses (97.0%; 95%CI 91.3;99.4; Kappa 0.922). In both conditions, despite achieving similar concordance correlation coefficients (ranging from weak to moderate), the mean number of upper teeth was lower in clinical examination (7.1 ± 5.2) compared with self-reported (8.6 ± 3.6), while the opposite was observed for lower teeth (clinical examination: 9.1 ± 3.4; self-reported: 6.6 ± 5.3). Larger differences were found among women of low income and educational levels. CONCLUSIONS: Our findings suggest that the participants' socio-economic position might influence their self-reported number of teeth.

Dental caries and depression in pregnant women: The role of oral health self-perception as mediator.

OBJECTIVE: This study investigated the role of oral health self-perception as mediator of association between dental caries and depression among pregnant women from the 2015 Pelotas Birth Cohort Study, Brazil. MATERIALS AND METHODS: Overall, 2,496 pregnant women participated of this oral health sub-study. Data related to demographic and socioeconomic conditions, lifetime and current depression, and oral health self-perception were collected. Participants were also assessed for dental caries (DMF-T index). Depression was assessed using the Edinburgh Postnatal Depression Scale. For analysis, six outcomes related to dental caries experience were considered. Causal mediation analysis was performed using parametric regression models. RESULTS: When it was assumed that all subjects had poor perception about oral health, it was observed that the presence of moderate/severe depressive signals and symptoms was higher in subjects with dental caries experience (OR 1.13; CI 95% 1.06-1.20), with severity of untreated dental caries (OR 2.08; CI 95% 1.16-3.78), untreated dental caries (OR 1.18; 95% CI 1.07-1.29), tooth loss (OR 1.08; 95% CI 1.02-1.14), and filled tooth (OR 1.07; 95% CI 1.02-1.16). CONCLUSIONS: Our findings show the effect of dental caries on depression is mediated by self-perception about oral health in pregnant women.

A multi-country survey on the impact of COVID-19 on dental practice and dentists' feelings in Latin America.

BACKGROUND: The COVID-19 pandemic has significantly influenced the routine of healthcare workers. This study investigated the impact of the pandemic on dental practice and dentists' feelings in Latin America. METHODS: A survey was conducted with dentists from 11 Spanish-speaking Latin American countries in September-December 2020. Professionals were invited by email and via an open campaign promoted on social media. The questions investigated dental care routines, practice changes, and feelings about the pandemic. Descriptive statistics were used to identify frequencies and distributions of variables. Proportions were compared using chi-square tests. RESULTS: A total of 2127 responses were collected from a sample with diverse demographic, sex, work, and education characteristics. The impact of COVID-19 was considered high/very high by 60% of respondents. The volume of patients assisted weekly was lower compared with the pre-pandemic period (mean reduction = 14 ± 15 patients). A high rate of fear to contracting the COVID-19 at work was observed (85%); 4.9% of participants had a positive COVID-19 test. The main professional challenges faced by respondents were reduction in the number of patients or financial gain (35%), fear of contracting COVID-19 (34%), and burden with or difficulty in purchasing new personal protective equipment (22%). The fear to contracting COVID-19 was influenced by the number of weekly appointments. A positive test by the dentists was associated with their reports of having assisted COVID-19 patients. The most cited feelings about the pandemic were uncertainty, fear, worry, anxiety, and stress. Negative feelings were more prevalent for professionals who did not receive training for COVID-19 preventive measures and those reporting higher levels of fear to contract the disease. CONCLUSION: This multi-country survey indicated a high impact of the pandemic on dental care routines in Latin America. A massive prevalence of bad feelings was associated with the pandemic.

Clinical and self-reported oral conditions and quality of life in the 1982 Pelotas birth cohort.

AIM: To investigate and compare the effects of clinical and self-perceived oral conditions on oral health-related quality of life (OHRQoL) among young adults. MATERIALS AND METHODS: Adults enrolled in the 1982 Pelotas birth cohort were included in this study. OHRQoL was assessed by the Oral Health Impact Profile-14 (OHIP-14) instrument. Clinical parameters such as dental caries, periodontitis, aesthetics, and occlusal characteristics, and tongue coating were collected through clinical evaluation, while dental anxiety and halitosis were self-reported. Direct and indirect effects of clinical and self-perceived oral conditions on OHRQoL were assessed using structural equation modelling. RESULTS: Five-hundred and thirty-nine individuals participated in this study. Dental caries (ß = 0.12) and periodontitis (ß = 0.11) were directly and indirectly (via halitosis, ß = 0.05 for periodontitis only) associated with greater OHIP-14 scores, while the other clinical conditions did not influence the OHIP-14 scores. Dental anxiety and halitosis were also associated with higher OHIP-14 scores (ß = 0.31 and ß = 0.27, respectively). CONCLUSIONS: This study found a positive association between clinically diagnosed and self-reported oral conditions and OHRQoL; however, the self-reported conditions had a higher impact on OHRQoL.

Periodontal disease and preterm birth: Findings from the 2015 Pelotas birth cohort study.

OBJECTIVES: To verify the association between periodontal conditions and preterm birth. MATERIALS AND METHODS: This study used data from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth in 2015 were interviewed and dentally examined by a trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Exposure was periodontal disease. Outcomes were preterm birth (all births <37 weeks of gestational age) and early preterm birth (<34 weeks). Analysis was carried out using Poisson regression according to a directed acyclic graph. RESULTS: A total of 2,474 women participated in the study. Incidence of preterm births was 10.2% and of early preterm births was 3.5%. Frequency of gingivitis was 21.7%, and periodontitis was 14.9%. Periodontitis was associated with a risk almost two times higher of having early preterm delivery compared with healthy pregnant women (RR 1.93; 95% CI 1.09-3.43). Presence of 5+ mm periodontal pocket with bleeding on probing was also associated with higher risk for early preterm delivery. CONCLUSIONS: The association between periodontal disease in pregnancy and the occurrence of preterm delivery is sensitive to the case definitions. Periodontal disease increased the risk of early preterm delivery.

The school social environment and oral health-related quality of life in children: a multilevel analysis.

This study aimed to explore the association between schoolchildren's oral health-related quality of life (OHRQoL) and the school-related social environment (contextual factors). A cross-sectional study was performed with 1,211 children, aged 8-12 yr, from 20 private and public schools. Sociodemographic information was collected from a questionnaire given to parents, and children were interviewed using the Child Perceptions Questionnaire (CPQ) and examined for oral health conditions. Contextual variables were obtained from school coordinators regarding the social environment. Data analysis was performed through multilevel Poisson regression. A high negative impact on OHRQoL was found for participants who were girls, older, had very severe malocclusion, had dental trauma and caries, and had mothers with less schooling. A negative impact on OHRQoL was also found for children who attended schools in which police security was required (rate ratios [RR] = 1.11; 95% CI: 1.01-1.22) and in which violence among students occurred in the last year (RR = 1.17; 95% CI: 1.02-1.35). The need for police security was associated with a negative impact on the emotional well-being domain, and violence among students was associated with negative impact on the oral symptoms, functional limitations, and social well-being domains. Children in healthier environments have better OHRQoL.

Periodontitis and self-reported halitosis among young adults from the 1982 Pelotas Birth Cohort.

OBJECTIVE: To investigate the association between periodontitis and self-reported halitosis among young adults, and whether there is an interaction between the effects of smoking and periodontitis on halitosis. METHODS: Data from the 1982 Pelotas birth cohort, Brazil, were used. The controlled direct effect of periodontitis on self-reported halitosis, not mediated by tongue coating, was estimated using marginal structural modeling. In addition, an interaction between the effects of smoking and periodontitis on halitosis was also tested. Confounders comprised sociodemographic information, obesity, diabetes, and oral hygiene habits. RESULTS: The controlled direct effect of periodontitis on halitosis not mediated by tongue coating showed that individuals with periodontitis had 90% higher risk of self-reporting halitosis (RR 1.90) compared to healthy individuals. Individuals with mild periodontitis had twice the risk of reporting halitosis than periodontally healthy individuals (RR 2.31). We also found an interaction between the effects of smoking and periodontitis on halitosis, as noted among smokers with mild (RR 2.91) and moderate-to-severe periodontitis (RR 5.84). CONCLUSION: There is a controlled direct effect of periodontitis on halitosis not mediated by tongue coating. Additionally, an interaction between the effects of smoking and periodontitis on halitosis was also detected.

Income at birth and tooth loss due to dental caries in adulthood: The 1982 Pelotas birth cohort.

OBJECTIVE: To estimate the effect of income at birth on adulthood tooth loss due to dental caries in 539 adults from the 1982 Pelotas birth cohort. METHODS: Family income was collected at birth. Tooth loss was clinically assessed when individuals were aged 31. Dental visit and oral hygiene at age 25 were considered mediators. Confounders included maternal skin color, and individual's skin color, sex, and income in adulthood. Marginal structural modeling was used to estimate the controlled direct effect of income at birth on tooth loss due to dental caries that was neither mediated by the use of dental service nor oral hygiene. RESULTS: Forty-three percent of the individuals of low income at birth lost one/two teeth, and 23% lost three or more; among those non-poor, the prevalence was 30% and 14%, respectively. Poor individuals at birth had a 70% higher risk for missing teeth in adulthood than those non-poor. The risk of losing one/two (risk ratio 1.68) and three or more teeth (risk ratio 3.84) was also higher among those of low income at birth. CONCLUSIONS: Economic disadvantage at birth had an effect on tooth loss due to dental caries at age 31 not mediated by individual risk factors.

The influence of breastfeeding and pacifier use on the association between preterm birth and primary-dentition malocclusion: A population-based birth cohort study.

INTRODUCTION: Little is known about the influence of biological characteristics on the occurrence of malocclusion. This study aimed to investigate the association between preterm birth and primary-dentition malocclusion and how breastfeeding and the use of pacifiers are related to this association. METHODS: A representative sample (n = 1129) of children from the 2004 Pelotas, Brazil birth cohort study underwent a dental examination at age 5 years. Malocclusions were diagnosed according to the World Health Organization criteria, and the outcome was considered as the presence of moderate or severe malocclusion (MSM). Questionnaires including the children's oral health information were completed by the mothers. Data on socioeconomic status, breastfeeding, and preterm birth were obtained from previous follow-ups. Poisson regression analysis was conducted, followed by an interaction test. RESULTS: The prevalence of MSM was 26.3% (95% confidence interval [CI], 23.6%-29.1%) in the total sample, 24.1% (95% CI, 21.5%-26.9%) in full-term births, and 42.2% (95% CI, 39.1%-45.3%) in preterm births. After adjustment, the prevalence of MSM was 42% higher in preterm births. Breastfeeding duration and pacifier use up to age 4 years modified the effect of gestational age on MSM. CONCLUSIONS: Preterm birth is associated with the development of MSM. Breastfeeding reduces the effect of preterm birth on MSM, and pacifier use strengthens this association. Dentists should be aware that preterm birth may be a risk factor for malocclusion in primary dentition. The findings reinforce the benefits of breastfeeding on occlusal development and the negative consequences of pacifier use.

Is there an association between depression and periodontitis? A birth cohort study.

AIM: To investigate the association between depression and periodontitis among adults enrolled in the 1982 Pelotas Birth Cohort, Brazil. MATERIALS AND METHODS: Major depressive episode (MDE) and severity of depressive symptoms obtained in 2012 were considered the exposure of this study. In 2013, periodontitis, the outcome of interest, was clinically assessed and two different case definitions were used: the CDC/AAP and a combination of clinical attachment loss (CAL) and bleeding on probing (BOP) simultaneously. Serum levels of C-reactive protein and frequency of dental flossing were defined as mediators while confounders comprised a set of variables collected throughout the life-course of the participants. The parametric g-formula was used to test the direct, indirect and total effects of depression on periodontitis. RESULTS: 539 participants were clinically examined. Individuals with depressive symptoms presented higher risk of periodontitis (risk ratio [RR] 1.19). The presence of depressive symptoms was also associated with moderate/severe periodontitis (total effect RR 1.18). None of the associations was mediated by flossing or C-reactive protein levels. Finally, neither the presence of depressive symptoms nor the presence of major depression was associated with the combination of CAL+BOP. CONCLUSIONS: A positive association between depressive symptoms and periodontitis and moderate/severe periodontitis was found. MDE was not associated with periodontitis.

Is composite repair suitable for anterior restorations? A long-term practice-based clinical study.

OBJECTIVES: This study investigated the impact in survival, when repair is seen as failure or not, in anterior composite restorations with a retrospective 15-year follow-up study. MATERIALS AND METHODS: Data was collected from patients' files of a private dental practice, including patients with direct composite restorations placed in anterior teeth (class III, class IV, or veneer) between January 1994 and December 2009. Data were analyzed considering or not repair as failure. Statistical analysis was performed with log rank test, Kaplan-Meier, and Cox regression (p < .05). RESULTS: One hundred forty-four patients' files were included, with 634 restorations. At 15 years, Class III / IV restorations showed 69% survival and 2.4% annual failure rate (AFR) when repair was not considered as failure, and 64% and 2.9% AFR, respectively, when repair was seen as failure. For direct veneers, at 5 and 10 years of follow-up, survival dropped from 85% to 74% and from 52% to 38% respectively, when repair was considered as failure. In general, restorations placed in the upper jaw showed increased risk for failure compared to the lower jaw (p < .01), and restorations in central incisors presented a higher risk for failure compared to canines (p < .01). CONCLUSION: Composite repair seems a suitable alternative for class III, class IV, and veneer restorations since it was able to increase the survival of restorations performed in anterior teeth. CLINICAL RELEVANCE: Composite repair for anterior restorations is a suitable restorative treatment option and presents benefits over replacement, including the preservation of sound tooth structures, reduced clinical chair time, and patient anxiety.

Proximal restoration increases the risk of clinical attachment loss.

AIM: To estimate the effect of proximal direct restorations in the adjacent periodontal tissues in adults from a birth cohort. MATERIALS AND METHODS: A representative sample (n = 539) of all 5,914 births occurring in Pelotas, Brazil in 1982 was prospectively investigated, being clinical attachment loss (CAL), probing depth (PD), and bleeding on probing (BOP) assessed at 31-year old. For each site, tooth surface was evaluated as sound or restored, being the restoration extension (subgingival or supragingival) and restoration material (composite and amalgam) considered. Covariables included family income, untreated caries, and service utilization patterns during life course. Multilevel Poisson regression models were used, considering three levels of variables organization: periodontal site, dental, and individual level. RESULTS: Among the 28,796 periodontal sites evaluated, CAL and PD ≥ 4 mm was observed in 1.5% and 4.8%, respectively. Multilevel models showed that proximal restorations had a significant effect on CAL and PD. Subgingival and amalgam restorations showed greater effect when compared to supragingival and composite restorations, respectively. CONCLUSIONS: The present study partially supports the hypothesis that proximal restorations are associated with the presence of periodontal damage. Although not indicative of disease, a significant increase was observed in CAL and PD at restored sites.

Effect of life-course family income trajectories on periodontitis: Birth cohort study.

AIMS: To quantify the impact of life course income trajectories on periodontitis in adulthood. MATERIALS AND METHODS: Data from the 1982 Pelotas Birth Cohort Study, Brazil, were used. Information on family income was collected at birth and ages 15, 19, 23 and 30 years. Group-based trajectory modelling was used to identify income trajectories. Periodontal measures were assessed through clinical examination at age 31. Log-Poisson regression models were used to estimate prevalence ratios (PRs) of any and moderate/severe periodontitis, as outcomes. RESULTS: Prevalence of any periodontitis and moderate/severe periodontitis was 37.3% and 14.3% (n = 539). Income trajectories were associated with prevalence of moderate/severe periodontitis. Adjusted PR in participants in low and variable income trajectory was 2.1 times higher than in participants in stable high-income trajectory. The unadjusted association between income trajectories and prevalence of any periodontitis was explained by the inclusion of behavioural and clinical variables in the model. CONCLUSIONS: Low and variable life course income increased the prevalence of moderate/severe periodontitis at age 31 years. The findings may inform programmes in identifying and targeting potentially at-risk groups during the life course to prevent periodontitis.

Anxiety symptoms have a direct effect on oral health perception in young women.

PURPOSE: Assess the influence of anxiety symptoms on oral health related-quality of life in young women from a cohort study in Southern Brazil. METHODS: A sample of 535 young mothers were analyzed. Interviews and psychological evaluations were carried out by trained psychologists. The Brazilian version of the Corah's dental anxiety scale and the Beck anxiety inventory were used to evaluate dental anxiety and anxiety symptoms, respectively. The oral health-related quality of life (OHRQoL) was assessed by the Oral Impacts on Daily Performance instrument. Dental examinations were performed by trained dentists to assess oral health status (DMFT). The effect of anxiety symptoms on oral health-related quality of life was estimated using the parametric g-formula. RESULTS: The prevalence of negative impact on OHRQoL was of 46.3 and 28% of the women presented anxiety symptoms. Unadjusted analysis showed that women with anxiety symptoms had 2.5 higher impact on OHRQoL (OR 2.55; CI 95% 1.72-3.79). The parametric g-formula revealed that anxiety had a direct effect on oral health perception (OR 1.16; CI 95% 1.04-1.30), not mediated by dental anxiety. CONCLUSION: Oral health-related quality of life is influenced by anxiety symptoms, regardless of dental anxiety.

Estimated prevalence of halitosis: a systematic review and meta-regression analysis.

OBJECTIVE: This study aims to conduct a systematic review to determine the prevalence of halitosis in adolescents and adults. METHODS: Electronic searches were performed using four different databases without restrictions: PubMed, Scopus, Web of Science, and SciELO. Population-based observational studies that provided data about the prevalence of halitosis in adolescents and adults were included. Additionally, meta-analyses, meta-regression, and sensitivity analyses were conducted to synthesize the evidence. RESULTS: A total of 584 articles were initially found and considered for title and abstract evaluation. Thirteen articles met inclusion criteria. The combined prevalence of halitosis was found to be 31.8% (95% CI 24.6-39.0%). Methodological aspects such as the year of publication and the socioeconomic status of the country where the study was conducted seemed to influence the prevalence of halitosis. CONCLUSIONS: Our results demonstrated that the estimated prevalence of halitosis was 31.8%, with high heterogeneity between studies. The results suggest a worldwide trend towards a rise in halitosis prevalence. CLINICAL RELEVANCE: Given the high prevalence of halitosis and its complex etiology, dental professionals should be aware of their roles in halitosis prevention and treatment.

Diet-Induced Overweight and Obesity and Periodontitis Risk: An Application of the Parametric G-Formula in the 1982 Pelotas Birth Cohort.

We aimed to estimate hypothetical effects of habits (smoking, alcohol consumption, and fat and carbohydrates consumption) combined with diet-induced overweight/obesity on the risk of periodontitis. The risk of any periodontitis, moderate/severe periodontitis, and the combination of bleeding on probing (BOP) and clinical attachment loss (CAL) was estimated using the parametric g-formula in adults aged 31 years from the 1982 Pelotas Birth Cohort in Brazil. Individuals in this cohort have been followed since birth. Hypothetical conditions were set independently for each risk factor and in combination for the entire population. A total of 539 participants had oral examinations in 2013. The cumulative 31-year risk under no intervention was 33.3% for any periodontitis, 14.3%, for moderate/severe periodontitis, and 14.7%, for BOP and CAL. According to our statistical approach, diet-induced overweight/obesity increased the risk of all outcomes: 11% (overweight) and 22% (obesity) higher risk of periodontitis; 12% (overweight) and 27% (obesity) higher risk of moderate/severe periodontitis; 21% (overweight) and 57% (obesity) higher risk of CAL and BOP. When overweight/obesity was combined with other unhealthy habits, the risk was even greater. Our findings suggest that the combination of diet-induced obesity with other risk factors may increase the risk of periodontitis. Further research in the field is required to corroborate our study.

Is periodontitis associated with halitosis? A systematic review and meta-regression analysis.

AIM: To systematically review the literature in order to investigate a potential association between periodontitis and halitosis. METHODS: Electronic searches were performed in four different databases: PubMed, Scopus, Web of Science and Scielo. Population-based observational studies that tested the association between periodontitis and halitosis were included. Additionally, meta-analysis, meta-regression and subgroup analyses were performed to synthesize the evidence. RESULTS: A total of 1,107 articles were identified in electronic searches; out of which, five were included within the meta-analysis. Pooled estimates revealed that individuals with periodontitis presented 3.16 times higher odds (OR 3.16; 95% CI: 1.12-8.95) of having halitosis. Meta-regression and subgroups analyses showed that criteria used for halitosis and periodontitis assessment explained nearly 45% and 24% of heterogeneity between studies, respectively. CONCLUSIONS: Positive association between periodontitis and halitosis was found in pooled results of population-based observational studies. However, this evidence is derived from cross-sectional studies.

Does periodontal treatment have an effect on clinical and immunological parameters of periodontal disease in obese subjects? A systematic review and meta-analysis.

AIM: The aim of this study was to systematically review the literature to answer the questions: (i) "Is periodontal treatment effective to improve clinical and immunological conditions in obese subjects?"; (ii) "Do obese subjects present different clinical and immunological response after periodontal therapy when compared to non-obese subjects?" METHODS: Searches were performed in six databases up to August 2014. Interventional studies were included if the following data were described: (1) Obesity/overweight assessment; (2) definition of periodontal disease; (3) periodontal therapy; (4) inflammatory marker in serum/plasma, and/or clinical parameters of periodontal disease. Assessment of quality was performed with the Downs and Black scale. Meta-analyses were conducted with the available data. RESULTS: Of 489 articles, 5 were included, and only 3 proceeded to meta-analysis of clinical outcomes. Included studies presented fair methodological quality. Statistical analysis demonstrated that periodontal therapy in obese subjects was effective to improve clinical outcomes. No clinical differences between post-therapy results of obese and non-obese were observed. Effects of periodontal therapy on inflammatory markers remain unclear. CONCLUSIONS: Periodontal treatment seems to be effective to improve healing in obese individuals. No differences on periodontal healing between obese and non-obese subjects were observed; however, only limited and fragile base of evidence was available for analysis. CLINICAL RELEVANCE: Periodontal treatment is effective to improve clinical and immunological periodontal parameters in adults. Also, obesity seems to not modify the periodontal healing after treatment.