NUTRITION Metabolic and bariatric surgery Nutrition and dental considerations

Background and Overview. Oral health care professionals may encounter patients who have had bariatric surgery and should be aware of the oral and nutritional implications of these surgeries. Bariatric surgery is an effective therapy for the treatment of obesity. Consistent with the 1991 National Institutes of Health Consensus Development Conference on Gastrointestinal Surgery for Severe Obesity recommendations, patients must meet body mass index (BMI) criteria for severe obesity, defined as a BMI greater than or equal to 40 kilograms per square meter, as well as for those with a BMI of greater than or equal to 35 kg/m(2) with significant comorbidities. Conclusions. Benefits of bariatric surgery in the treatment of severe obesity include significant and durable weight loss and improved or remission of obesity-related comorbidities including type 2 diabetes, hyperlipidemia, hypertension, heart disease, obstructive sleep apnea, and depression. Of the limited data published concerning the influences of bariatric surgical procedures on oral health, increased incidence of dental caries, periodontal diseases, and tooth wear have been reported in patients post-bariatric surgery. Practical Implications. The oral health care practitioner familiar with the most common bariatric procedures performed in the United States and their mechanisms of actions, risks, and benefits is in the position to provide guidance to patients on the nutritional and oral complications that can occur.