Obesity and Oral Health: Clinical Associations, Mechanistic Evidence, and Implications for Dental Care—A Narrative Review

Abstract

Obesity is a heterogeneous multisystem condition characterized by chronic low-grade inflammation, oxidative stress, adipokine dysregulation, and insulin resistance; its effects on oral microbial homeostasis, tissue regeneration, and disease susceptibility vary with metabolic context and with the outcome examined. This narrative review synthesizes evidence on the mechanisms linking obesity to oral disease and on its implications for dental prevention, periodontal care, implant therapy, and oral surgery. MEDLINE via PubMed, Scopus, and Web of Science Core Collection were searched from January 2000 to 31 August 2026, with the final search performed on 10 September 2026. The strength of evidence differs markedly by outcome. Human epidemiological studies support an association with periodontitis; altered salivary flow and composition are reported mainly in cross-sectional studies. Proposed effects on osseous healing and jawbone remodeling rest substantially on experimental and systemic bone research, and specific marrow alterations remain poorly established. Obesity is associated with selected peri-implant inflammatory outcomes, whereas evidence on implant survival is less consistent; these findings establish neither impaired primary osseointegration nor a contraindication to implant therapy. Associations with caries appear largely attributable to shared determinants. The phenotype-aware framework proposed here is hypothesis-generating and requires prospective interventional validation.