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Influência da cirurgia bariátrica na saúde oral : uma revisão narrativa
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Abstract(s)
A obesidade é uma doença crónica, complexa e multifatorial, constituindo um problema de saúde pública a nível mundial pois encontra-se associado a alguma das mais prevalentes doenças crónicas não transmissíveis da sociedade moderna (WHO, 2022). Para além disso, atualmente tem sido relatado uma associação entre a obesidade e diversas alterações na cavidade oral, como a presença de lesões de cárie, a erupção dentária precoce, o edentulismo, a doença periodontal, a xerostomia e o aparecimento do cancro da cabeça e pescoço (Suvan & D’Ajuto, 2013)
Atualmente, o tratamento para esta doença crónica centra-se nas modificações do estilo de vida, aliando o cumprimento de uma alimentação equilibrada à prática de atividade física regular e às mudanças comportamentais (Kheniser et al., 2021) Contudo, verifica-se que este conjunto de medidas têm eficácia limitada a longo prazo. A Cirurgia Bariátrica é um procedimento que tem vindo a ser efetivo no tratamento de doentes com obesidade mórbida porque, além de ser eficaz na perda de peso, está associada à prevenção, melhoria ou resolução das comorbilidades associadas à obesidade (Colquitt et al., 2014). Contudo, todas as cirurgias realizadas atualmente resultam em mudanças drásticas na anatomia gastrointestinal, na fisiologia e nos hábitos alimentares, podendo trazer consequências a vários níveis, incluindo a nível oral (Garcia-Sanchez et al., 2022).
As consequências descritas na literatura relativamente às manifestações orais foram aumento de acumulação de placa bacteriana, aumento da incidência de cárie dentária e doença periodontal, diminuição do fluxo salivar e desgaste dentário (Garcia-Sanchez et al., 2022).
A escassez de estudos longitudinais sobre as possíveis alterações na saúde oral de pacientes obesos e de pacientes submetidos a cirurgia bariátrica justifica novas investigações que possam trazer à luz do conhecimento informações relevantes para a prevenção e tratamento oral desses pacientes.
Obesity is a chronic, complex and multifactorial disease, constituting a worldwide public health problem as it is associated with some of the most prevalent chronic non-communicable diseases in modern society, such as Type 2 Diabetes Mellitus, Cardiovascular Diseases, some types of Cancer and chronic respiratory diseases (WHO, 2022; Segula 2014; De Lorenzo et al., 2019). In addition, an association has now been reported between obesity and various alterations in the oral cavity, such as the presence of caries lesions, early tooth eruption, edentulism, periodontal disease, xerostomia and the appearance of head and neck cancer (Suvan & D'Ajuto, 2013). Currently, treatment for this chronic disease focuses on lifestyle modifications, combining adherence to a balanced diet with regular physical activity and behavioural changes (Kheniser et al., 2021). However, this set of measures has limited long-term effectiveness. Bariatric surgery is a procedure that has been effective in treating patients with morbid obesity because, as well as being effective in weight loss, it is associated with the prevention, improvement or resolution of comorbidities associated with obesity (Colquitt et al., 2014). However, all surgeries performed today result in drastic changes to the gastrointestinal anatomy, physiology and eating habits, which can have consequences at various levels, including the oral level (Garcia-Sanchez et al., 2022). The consequences described in the literature in relation to oral manifestations were increased plaque accumulation, increased incidence of dental caries and periodontal disease, decreased salivary flow and tooth wear (Garcia-Sanchez et al., 2022). The scarcity of longitudinal studies on the possible changes in the oral health of obese patients and patients undergoing bariatric surgery justifies new research that can bring to light relevant information for the prevention and oral treatment of these patients.
Obesity is a chronic, complex and multifactorial disease, constituting a worldwide public health problem as it is associated with some of the most prevalent chronic non-communicable diseases in modern society, such as Type 2 Diabetes Mellitus, Cardiovascular Diseases, some types of Cancer and chronic respiratory diseases (WHO, 2022; Segula 2014; De Lorenzo et al., 2019). In addition, an association has now been reported between obesity and various alterations in the oral cavity, such as the presence of caries lesions, early tooth eruption, edentulism, periodontal disease, xerostomia and the appearance of head and neck cancer (Suvan & D'Ajuto, 2013). Currently, treatment for this chronic disease focuses on lifestyle modifications, combining adherence to a balanced diet with regular physical activity and behavioural changes (Kheniser et al., 2021). However, this set of measures has limited long-term effectiveness. Bariatric surgery is a procedure that has been effective in treating patients with morbid obesity because, as well as being effective in weight loss, it is associated with the prevention, improvement or resolution of comorbidities associated with obesity (Colquitt et al., 2014). However, all surgeries performed today result in drastic changes to the gastrointestinal anatomy, physiology and eating habits, which can have consequences at various levels, including the oral level (Garcia-Sanchez et al., 2022). The consequences described in the literature in relation to oral manifestations were increased plaque accumulation, increased incidence of dental caries and periodontal disease, decreased salivary flow and tooth wear (Garcia-Sanchez et al., 2022). The scarcity of longitudinal studies on the possible changes in the oral health of obese patients and patients undergoing bariatric surgery justifies new research that can bring to light relevant information for the prevention and oral treatment of these patients.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Obesidade Tratamento da obesidade Cirurgia bariátrica Saúde oral Manifestações orais