Obesity in Children and Adolescents - a New Challenge in Orthodontic Practice

Obesity is one of the most common chronic disorders affecting the health and well-being of children and adolescents and its prevalence is increasing steadily and dramatically all over the world. Because of the growing number of overweight or obese children and adolescents in orthodontic practice, the aim of the study was to discuss a variety of medical and psychosocial issues associated with childhood obesity which may have an impact on orthodontic therapy. Overweight and obesity are usually associated with the early onset of puberty and earlier pubertal growth spurt. Obesity has been hypothesized to impact craniofacial growth and lead to more precocious skeletal maturation of the maxilla and the mandible, which has a fundamental significance in dentofacial orthopaedics. An acceleration of dental development in obese children may alter the diagnosis and timing of orthodontic treatment. In fact, when incorporating orthodontic therapies such as growth modification or serial extractions, the timing of intervention may require recalculation to consider also the weight status of the patient. Based on available literature, obesity seems to impact bone metabolism through several mechanisms, which may considerably affect the orthodontic tooth movement. Obesity in childhood and adolescence is associated with significant psychosocial problems, which are probably more common than medical consequences. Most typical complications are related to psychosocial dysfunction and social isolation. Obesity in childhood and adolescence should be considered as a chronic medical condition associated with a multitude of medical and psychosocial consequences, which may influence orthodontic therapy