Type 1 diabetes and oral health: Findings from the Epidemiology of Diabetes Interventions and Complications (EDIC) study

Larissa Steigmann, University of Michigan, School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, MI, United States.
Ryan Miller, University of Maryland, School of Medicine, Division of Pediatric Endocrinology, Baltimore, MD, United States.
Victoria R. Trapani, George Washington University, Biostatistics Center, Rockville, MD, United States.
William V. Giannobile, Harvard University, School of Dental Medicine, Department of Oral Medicine, Infection, and Immunity, Boston, MA, United States.
Barbara H. Braffett, George Washington University, Biostatistics Center, Rockville, MD, United States.
Rodica Pop-Busui, University of Michigan, School of Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Ann Arbor, MI, United States.
Gayle Lorenzi, University of California, San Diego, School of Medicine, Department of Medicine, Division of Metabolism, Endocrinology and Diabetes, La Jolla, CA, United States.
William H. Herman, University of Michigan, School of Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Ann Arbor, MI, United States; University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, MI, United States.
Aruna V. Sarma, University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, MI, United States; University of Michigan, School of Medicine, Department of Urology, Ann Arbor, MI, United States. Electronic address: asarma@umich.edu.

Document Type

Journal Article

Publication Date

1-3-2022

Journal

Journal of diabetes and its complications

DOI

10.1016/j.jdiacomp.2021.108120

Keywords

Disease progression; Oral health outcomes; Periodontitis; Tooth loss; Type 1 diabetes

Abstract

OBJECTIVE: To describe long-term oral health outcomes and examine associations between sociodemographic factors, clinical characteristics, and markers of diabetes control on tooth loss in participants with type 1 diabetes enrolled in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. RESEARCH DESIGN AND METHODS: Oral health outcomes related to tooth loss were reported at annual visits during EDIC years 22-26 (2015-2019). Generalized estimating equation models were used to assess the association of individual risk factors and tooth loss, over repeated time points. RESULTS: A total of 165 (17%) participants with type 1 diabetes reported 221 oral health outcomes related to tooth loss over a five-year period. After controlling for age and current tobacco use, the presence of diabetic peripheral neuropathy was significantly associated with an increased odds of tooth loss (OR = 1.88, 95% CI 1.24, 2.87) while higher mean HDL/LDL cholesterol ratio was significantly associated with a decreased odds of tooth loss (OR = 0.87, 95% CI = 0.79, 0.97). CONCLUSIONS: These findings suggest that diabetes-related complications, either resulting from or independent of poor glycemia, may be directly associated with oral health conditions, and support the need for individuals with type 1 diabetes and providers to implement lifestyle and medical interventions to reduce oral health risks.

Department

Epidemiology

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