Study finds increased rate of tooth loss in diabetics

The CDC recently announced that diabetes rates in the United States have dropped for the first time in 25 years – but the news wasn’t so positive for dental health. Although diabetes rates are dropping, diabetics are still twice as likely as their non-diabetic counterparts to lose teeth.

A new study out of Duke University examined trends in tooth loss between 1971 and 2012. Using data from nine National Health and Nutrition Examination Surveys, researchers looked at tooth loss numbers from over 37,000 people with and without diabetes. The study also assessed tooth loss patterns by racial background, age group and birth cohort.

Researchers discovered that people with diabetes face approximately double the risk of tooth loss than those without the disease. While tooth loss rates for adults have declined since 1971, “among people 18 or older [researchers] found that adults with diabetes had 1.5 times the odds of having at least one tooth removed as adults of the same age without diabetes,” the study reported.  In 1999, for example, people with diabetes were 34% more likely to have less than 21 teeth.

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In addition, researchers found that Hispanics were at a lower risk of tooth loss than non-Hispanic whites and African Americans. African Americans with diabetes were at the highest risk of tooth loss, perhaps, the study states, because of “the persistently lower rate of dental care in [African Americans]  … due to a challenge obtaining proper dental care because of a lack of dental services and dental knowledge.” This, the researchers claimed, could be attributed to a lack of access to dental care in their youth for many older African Americans in the earlier part of the 20^th century.

Researchers also cited an earlier study that found that in 1977, 46.9% of non-Hispanic whites reported visiting a dentist in the past year, as opposed to only 23.4% of African Americans.

“Regardless of diabetes status or race/ethnicity, the differences in slopes diverged more for older cohorts,” the study continued. “Better access to dental care, more awareness and knowledge of oral health, technological change, and improvements in dental hygiene practice could account for the convergence in trends in tooth loss (ie, smaller differences) in younger cohorts.”

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Interestingly, the study also discovered that diabetics were less likely to see a dentist regularly. “Adults with diabetes were less likely to have seen a dentist than those without diabetes within the past 12 months (65.8% vs. 73.1%),” the study reported.

“Our study found that substantial differences in tooth loss between adults with and without diabetes have persisted over time,” researchers concluded. “Adults with diabetes lost more teeth than adults without the disease. African Americans with diabetes lost the largest number of teeth, and they had the greatest increase in tooth loss as they aged. The importance of necessary dental care and tooth retention needs to be further promoted among patients and clinical providers.” 

The full study, “Forty-year trends in tooth loss among American adults with and without diabetes mellitus: An age-period –cohort analysis,” was published in Preventing Chronic Disease in December 2015.