Associations and trends between chronic diseases and tooth loss – BRFSS, 2012-2018

Abstract

OBJECTIVE: To examine associations and trends between chronic diseases and tooth loss using BRFSS 2012-2018. METHODS: Self-reported permanent tooth loss from tooth decay/gum disease and several self-reported chronic disease diagnoses were analyzed by cycle (2012, 2014, 2016, 2018) to explore associations and trends. Chi-square analyses were performed for the primary outcome of one or more teeth lost with the following ailments: physical health, mental health, weight, diabetes, myocardial infarction, coronary heart disease, stroke, asthma, cancer, respiratory diseases, arthritis, and kidney disease. Multivariate logistic regressions were performed to estimate the odds for tooth-loss for each disease using gender, age, race, insurance, income, education and smoking as covariates. Effects of one or more concurrent chronic disease diagnoses on tooth loss were calculated and 2012-2018 results compared. Interaction between disease and year were used in the multivariate regression aanalyses to find differences in tooth loss from 2012- 2018. All calculations were performed using SAS 9.4. RESULTS: Tooth loss has declined from 45% - in 2012 to 39% - in 2018 in individuals with one chronic disease. A similar decline in tooth loss is seen in those with two, three, four or more chronic diseases. Increased tooth-loss was significantly associated with each chronic disease, with adjusted odds of tooth-loss ranging from 1.08-1.72. Diabetics, had an increased and significant odds of tooth loss with time: 1.36 (2012)-1.54 (2018). The odds of tooth-loss increased as number of concurrent chronic diseases increased -1.2 (one chronic disease)-2.4 (four or more chronic diseases). CONCLUSION: Fewer people are losing teeth, but those with chronic disease experience higher odds of tooth-loss. Having more concurrent diseases is associated with increased tooth-loss. Oral health is essential for overall health, therefore access to oral health care and educating the public and health professionals about these associations is vital.