Diabetes mellitus and its association with dental caries, missing teeth and dental services utilization in the US adult population: Results from the 2015–2018 National Health and Nutrition Examination Survey

Aims: This study aimed to evaluate the associations of self-reported diabetic status with clinically assessed dental end points, including teeth with untreated coronal and root caries, missing teeth, complete tooth retention, edentulism and routine dental services utilization among adults aged ≥20 years in the United States. Methods: We pooled data from the 2015–2016 and 2017–2018 cycles of the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional, continuous survey of noninstitutionalized US population. The analysed data included all adult participants aged ≥20 years who completed the dental examination and reported their diabetic status. We estimated the prevalence and average outcomes of dental end points by diabetic status. Regression analyses were employed to evaluate the associations between diabetic status and dental outcomes. Results: Of 10,249 participants, 1,562 reported having diabetes mellitus, which translates to 11.3% of US adults aged ≥20 years (25.7 million). Compared to non-diabetic individuals, adults with diabetes had 1.49 (95%CI = 1.1–2.0) and 1.46 (95%CI = 1.2–1.8) times higher odds of developing coronal and root caries respectively. Adults with diabetes were 32% less likely to be fully dentate (OR = 0.68; 95%CI = 0.55–0.83) and had a higher average number of missing teeth (mean ratio = 1.35; 95%CI = 1.18–1.55). There was no association between diabetic status and routine dental services utilization. Conclusions: Adults with diabetes exhibited worse dental health; nonetheless, there was no difference in dental services utilization. Multidisciplinary efforts from both medical and dental service providers are required to proactively address the well-being of adults with diabetes in terms of oral health.