The Justification for Dynamic Dental Monitoring of Oral Health Status in a Patient With Iii Class Obesity During Conservative Medical Therapy: A Clinical Case

Relevance: The pathogenesis of obesity is closely linked to the development of metabolically driven low-grade systemic inflammation, insulin resistance, and micronutrient imbalances. These background changes create potential predisposing factors to disturbances in oral health; however, to date it has not been definitively established what the oral health status is in patients with obesity, how it changes as obesity progresses, whether there are specific risks concerning the dental system in patients receiving obesity therapy, and which types of dental care can mitigate these risks. Those are the problems that justify the relevance of the present observation. Description of the clinical case: A patient with morbid obesity receiving orlistat therapy presented with severe chronic generalized periodontitis, exacerbation (K05.32), multiple caries (K02.8), and malocclusion (K07.4). Baseline periodontal indices (BOP-92 %, PPD-4.8 mm) and the Approximal Plaque Index (API 60 %) confirmed inflammation against a background of metabolic disturbances, while microbiological testing revealed dominance of ‘‘red complex’’ periodontopathogens. After 3 months of treatment, a modest weight loss (3 kg) and improvement in oral health were documented (BOP decreased to 38 %, API improved to 45 %). Discontinuation of orlistat at 6 months and non adherence to dental recommendations led to regression: by 12 months, the parameters had returned to baseline (BOP 88 %, PPD 4.7 mm), and body weight reached 159 kg. Conclusion: Oral health status in patients with morbid obesity may serve as a marker of systemic disturbances, and its dynamic monitoring enables evaluation of changes during therapy. In the described case, aggressive periodontitis with dominance of red complex pathogens, multiple approximal caries, and poor oral hygiene were identified, reflecting the influence of metabolic and dietary factors. Regular monitoring detects periods at risk for exacerbation, thereby substantiating the need for an interdisciplinary approach and continuous surveillance.