University of Oulu

Kangas et al. BMC Oral Health (2017) 17:48, DOI 10.1186/s12903-017-0336-y

Waist circumference and waist-to-height ratio are associated with periodontal pocketing : results of the Health 2000 Survey

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Author: Kangas, Sanna1; Timonen, Petra2; Knuuttila, Matti3;
Organizations: 1Private Dental Office Viisaudenhammas
2Dental Training Clinic, Social and Health Services
3Medical Research Center Oulu, Oulu University Hospital and University of Oulu
4National Institute for Health and Welfare (THL)
5Periodontology and Geriatric Dentistry, Unit of Oral Health Sciences Research
6Institute of Dentistry, University of Eastern Finland
7Oral and Maxillofacial Department, Kuopio University Hospital
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: Springer Nature, 2017
Publish Date: 2017-04-06


Background: Body mass index (BMI) has been found to associate with different parameters of chronic periodontal disease in previous studies. It is reasonable to expect that central adiposity measures, such as waist circumference and waist-to-height ratio, which indirectly takes into account visceral fat, are more accurate measures of obesity-related oral health risks than BMI. The aim of this study was to examine whether central obesity is associated with periodontal pocketing, an indication of infectious chronic periodontal disease.

Methods: The study was based on a subpopulation from the national Health 2000 Survey in Finland. It included dentate, non-diabetic, never-smoking subjects aged 30–49 (n = 1287). The outcome variable was the number of teeth with deepened periodontal pockets (4 mm or more) and the number of teeth with deep periodontal pockets (6 mm or more). Central obesity was measured by means of waist circumference (WC) and waist-to-height ratio (WHtR). Poisson regression models were used to estimate prevalence rate ratios (PRR) and their 95% confidence intervals.

Results: Our main finding was that both WC and WHtR were associated with the number of teeth with deeper (4 mm or more) periodontal pockets; the PRR for the fifth quintile in WC was 1.5, CI: 1.2–1.9 and in WHtR 1.4, CI: 1.1–1.7, when compared to the lowest quintile. Corresponding figures for deep (6 mm or more) periodontal pockets were 2.3, CI: 0.9–6.1 for WC and 1.9, CI: 0.8–4.4 for WHtR. There were no essential differences in the strengths of the associations between WC and WHtR and the number of teeth with deepened periodontal pockets.

Conclusion: Both central adipose measures—WC and WHtR—seem to be associated with periodontal pocketing in non-diabetic, never-smoking subjects aged 30–49 years old.

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Series: BMC oral health
ISSN: 1472-6831
ISSN-E: 1472-6831
ISSN-L: 1472-6831
Volume: 17
Article number: 48
DOI: 10.1186/s12903-017-0336-y
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Funding: Health 2000 Survey is supported by National Institute for Health and Welfare (THL), the former Public Health Institute (KTL) of Finland (, the Finnish Dental Society Apollonia and the Finnish Dental Association.
Dataset Reference: Health 2000 Survey data are available from National Institute for Health and Welfare (THL) on request. Additional information can be obtained from
Copyright information: © The Author(s). 2017. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.