The goal of this study is to investigate the long-term changes in host epigenetic modifications in obese individuals with periodontitis. The aims of the study are:

• To monitor longitudinal changes in host epigenetic modifiers following non-surgical periodontal therapy in periodontitis patients Study subjects would be categorized into two groups, non-obese with periodontitis, and obese with periodontitis. The study will primarily evaluate changes among these groups cross-sectionally, then longitudinally following non-surgical periodontal therapy (deep cleaning) to determine if any changes occur with treatment.

Periodontitis is an inflammatory disease process primarily caused by microorganisms, which affects the tooth-supporting structures and can eventually lead to tooth loss. Oral health is a reflection of general health. Accordingly, obesity can influence periodontitis and increase its severity. The study participants will be categorized into two groups as described above. Enrolled participants will be balanced for distribution of age, gender, ethnicity, and general health.

The objective of this pilot study is to investigate the cross-sectional and longitudinal changes in host epigenetic modifications in obese individuals with periodontitis. The investigators intend to examine these host epigenetic changes in obese and non-obese individuals with both periodontal health and periodontitis. The study will primarily evaluate longitudinal changes following non-surgical periodontal therapy (considered the gold standard for the initial treatment of periodontitis) to determine whether any modifications occur with treatment.

To control for other factors affecting periodontitis, the investigators plan to exclude diabetic participants, document oral hygiene habits, and monitor periodontal microorganisms and inflammatory mediators in the groups for further associations. In summary, the study will identify important epigenetic signatures in obese participants with periodontal disease compared to those with periodontal health as a potential causal factor linking the two conditions.

The investigators hypothesize that epigenetic programs in obese individuals will influence the severity of periodontal disease by altering inflammatory pathways and the microbial environment.

Inclusion Criteria:

• Adults aged ≥18 years,
• No history of periodontal therapy in the last 6 months,
• No use of tobacco,
• No history of pregnancy lactation or contraceptive medication.
• Need to have a minimum of 20 teeth.

Exclusion Criteria:

• Had antimicrobial/antiviral therapy in the previous 3 months,
• History of uncontrolled diabetes,
• History of rheumatoid arthritis,
• History of osteoporosis,
• History of oral cancer,
• Currently taking hormonal contraception,
• If pregnant or lactating currently or prior 6 months,
• Subjects on current weight loss drugs
• If planning weight reduction surgery during the time of the study
• Any other condition, disease or therapy with documented influence on oral inflammation and/or oral microbial environment.

Aggregated data will be published as a peer reviewed manuscript.