Trends and Risk Factors of Oral Health and Preventive Dental Care in Adults With Diabetes and Prediabetes: National Health and Nutrition Examination Survey 1999-2000 to 2017-2020.

Objective: To evaluate the prevalence, trends, and risk factors of major oral health indicators across diabetes mellitus (DM) subgroups.

Methods: A total of 22 082 adults of diagnosed DM, undiagnosed DM (UnDxDM), prediabetes mellitus (PreDM), and normal glucose groups were selected from the National Health and Nutrition Examination Survey (1999 to March 2020). We examined age, sex, and race-adjusted prevalence of preventive dental service (preventive dental service and self-dental cleaning) and oral health outcomes (≥10 missing teeth, self-rated oral health, and periodontitis). We used logistic regression to identify risk factors associated with each outcome DM population.

Results: The prevalence of lacking preventive dental service (DM, 52%; UnDxDM, 48%; PreDM, 44%; and normal, 42%, respectively), self-dental cleaning (38%, 37%, 30%, and 25%, respectively), missing teeth (39%, 31%, 19%, and 10%, respectively), poorly self-rated oral health (38%, 26%, 31%, and 27%, respectively), and periodontitis (50%, 51%, 42%, and 29%, respectively) remained consistently higher in those with DM than in normal glucose group. We observed a decline in the prevalence of lacking self-dental cleaning in the PreDM population and a decline in poorly self-rated oral health in all except the UnDxDM group. In the DM population, education, income, smoking, insurance, and glycemic control are risk factors for all outcomes.

Conclusion: The trends of lacking preventive dental care and suboptimal oral health outcomes were consistently higher in people with DM or PreDM than in those people without diabetes.