Interplay of Demographic Factors, Behavioral Factors, and Chronic Disease Status with Diabetes and Tooth Loss

Abstract

Tooth loss is associated with type 2 diabetes, but the extent to which demographic, behavioral, and health factors influence this association remains unclear. To evaluate this association, the 2022 Behavioral Risk Factor Surveillance System (BRFSS) data for 26,152 Washington State adults who provided information on variables of interest was analyzed. Participant characteristics were summarized by frequencies and percentages overall and stratified by tooth loss and diabetes status. Two models were fit to assess the association between self-reported diabetes (yes/no) and tooth loss (none, 1–5 teeth lost, ≥6 teeth lost); a crude model and a fully adjusted multinomial logistic regression model to assess the association controlling for age, sex, race/ethnicity, education, income, insurance status, marital status, county, smoking status, obesity, and cardiovascular disease. An exploratory analysis restricted to adults aged ≥45 years used the same modeling approach. All analyses were conducted in R. Among participants, 11.6% reported diabetes; 28.3% lost 1–5 teeth, 12.5% lost ≥ 6 teeth, and 59.2% reported no tooth loss. In adjusted multinomial model of 17, 373 adults, diabetes was an independent predictor of losing ≥6 teeth (adjusted OR = 1.79; 95 % CI, 1.35–2.37; p < 0.001). Older age, lower household income, lack of private health insurance, unemployment, current or former smoking, and cardiovascular disease were also significantly associated with severe tooth loss. Conclusion: Greater tooth loss was significantly associated with diabetes. This association was impacted by age, income, employment, smoking, and cardiovascular disease status.