June 2023

Objectives: To determine the relationship between diabetes and dental caries among US adults participating in the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Basic research design: The NHANES was a cross-sectional study including clinical assessments, laboratory analysis, and interviews. The sample included 16,635 participants aged 20 years and older that represent 187,596,215 individuals in the US in a probability weighted sample. Outcome variables included overall total caries score (or number of decayed, missing, filled permanent teeth – DMFT index) and the presence of caries. Bivariate analysis, Poisson regression for total caries score, logistic regression for the presence of caries were used for analysis. Results: Controlling for covariates, multiple Poisson regression revealed that total DMFT scores were associated with diabetes status (adjusted relative risk ratio (RR)controlled diabetes = 1.13, RRuncontrolled = 1.18; p<0.001), no college education, female sex, white race, elderly (≥ 65 years), cigarette smoking, obesity, yearly dental visits, diabetes seeing a dentist only for treatment. Similarly, multiple logistic regression shows that the odds of adults with diabetes having dental caries were higher than among those without diabetes (adjusted risk ratio (OR)controlled diabetes = 1.84, ORuncontrolled diabetes = 1.87; p<0.05). Conclusions: Diabetes was associated with a higher caries score and a greater risk for dental caries among US adults. Keywords: oral health, dental caries, United States, glycemic control, adult, dental public health