CHANGES IN ORAL HEALTH IN PATIENTS AFTER BARIATRIC SURGERY.

Resumo

Introduction: Obesity is considered a multifactorial chronic disease associated with several systemic comorbidities, with bariatric surgery b eing one of the main therapeutic alternatives for the treatment of morbid obesity and improvement of individuals' quality of life. Despite the metabolic benefits and the reduction of associated diseases, alterations resulting from bariatric surgery can negatively impact oral health due to physiological, dietary, and gastrointestinal changes observed in the postoperative period. Among the main repercussions described are periodontal disease, dental erosion, xerostomia, hyposalivation, gastroesophageal reflux , dental hypersensitivity, and alterations in the oral microbiota. Furthermore, nutritional deficiencies resulting from malabsorption of vitamins and minerals can compromise bone and dental structures, reinforcing the need for multidisciplinary follow -up for these patients. Objective: To analyze the main repercussions of bariatric surgery on oral health, highlighting the most frequent oral changes observed in the postoperative period. Materials and Methods: This is a narrative literature review based on scientific articles published in the PubMed, SciELO, LILACS, and Virtual Health Library databases. Observational studies, integrative reviews, and systematic reviews published between 2009 and 2025, in Portuguese and English, were included. The descriptors us ed were: "bariatric surgery," "oral health," "dentistry," "dental erosion," "periodontal disease," and "salivary flow." Results: The analyzed studies demonstrated that patients undergoing bariatric surgery have a greater predisposition to developing signif icant oral alterations. Gastroesophageal reflux and frequent episodes of vomiting were associated with increased erosion and tooth wear due to recurrent exposure of the teeth to gastric acid. Salivary alterations, such as hyposalivation and xerostomia, wer e also frequently observed, favoring the development of dental caries and oral discomfort. Studies have pointed to an increased prevalence of periodontal disease after bariatric surgery, associated with both systemic inflammatory conditions and metabolic a nd nutritional alterations resulting from the procedure. Furthermore, post -surgical dietary changes, such as increased meal frequency and higher consumption of soft and acidic foods, contribute to the worsening of oral conditions. Alterations in the saliva ry and oral microbiome have also been described, indicating a possible microbial imbalance related to post-bariatric surgery. Deficiencies in calcium, vitamin D, iron, and vitamin B12 can compromise bone metabolism and promote tooth loss and rehabilitation difficulties. Despite the systemic benefits of bariatric surgery, several studies show a significant negative impact on oral health and oral health-related quality of life in patients. Conclusion: Bariatric surgery has significant repercussions on oral health, including dental erosion, periodontal disease, hyposalivation, xerostomia, salivary changes, and an increased risk of dental caries. These changes are mainly related to gastroesophageal reflux, dietary changes, and nutritional deficiencies resulting from the surgical procedure. Therefore, integrated dental follow- up with a multidisciplinary team is essential for the prevention, early diagnosis, and treatment of oral alterations in bariatric patients.