Adults With Diabetes Lose Twice as Many Teeth as Other Adults

Adults with diabetes lost twice as many teeth as adults who did not have the disease, with more pronounced tooth loss seen among aging non-Latino blacks with diabetes, according to a cohort analysis published online December 3 in Preventing Chronic Disease.

"Our study found that substantial differences in tooth loss between adults with and without diabetes have persisted over time," Huabin Luo, PhD, from the Brody School of Medicine, East Carolina University, Greenville, North Carolina, and colleagues write. "Adults with diabetes lost more teeth than adults without the disease. Non-Hispanic blacks with diabetes lost the largest number of teeth, and they had the greatest increase in tooth loss as they aged."

As of 2012, an estimated 28.9 million adults aged 20 years and older in the United States had diabetes, including 13.2% of non-Latino blacks, 12.8% of Latinos, and 7.6% of non-Latino whites, according to the researchers. To better characterize the relationship between diabetes and tooth loss, Dr Luo and coauthors examined National Health and Nutrition Examination Survey data from 1971 through 2012 and classified 37,609 adults aged 25 years and older into birth cohorts in their sample.

They found that people with diabetes were older, had lower incomes and lower educational achievement, and had significantly more tooth loss than adults who did not have diabetes. Black non-Latino adults born from 1930 to 1934 and from 1935 to 1939 had more tooth loss than adults born immediately before or after. "This finding may suggest the impact of common historical events (eg, the Great Depression) at birth," the authors note. Overall, functional dentition (having more than 21 teeth) increased for people with diabetes, rising from 38.6% in 1971 to 68.8% in 2012.

The differences seen in tooth loss for people with diabetes have important implications, the authors write. "We found that trend lines in the number of teeth lost diverged more after age 60 among the three racial/ethnic groups. In addition, the rate of tooth loss increased more with age among non-Hispanic blacks than among non-Hispanic whites and Mexican Americans; and non-Hispanic blacks with diabetes had the fastest increase in rate of tooth loss. These findings indicate the cumulative effects of aging on tooth loss, especially among non-Hispanic blacks with diabetes," Dr Luo and colleagues write.

Because previous work has shown that people with diabetes brush and floss their teeth less often, the researchers say their study underscores the need to improve "dental self-care" and to enhance patients' knowledge, especially for non-Latino black patients, of diabetes risks.

"Growing evidence shows that oral health is associated with general health," the authors conclude. "To control diabetes complications, an interprofessional and team-based approach is needed to ensure better care coordination and disease management."

The authors have disclosed no relevant financial relationships.

Prev Chronic Dis. Published online December 3, 2015. Full text

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