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

J Diabetes Complications. 2022 Apr;36(4):108120. doi: 10.1016/j.jdiacomp.2021.108120. Epub 2022 Jan 3.


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.

Trial registration: ClinicalTrials.gov NCT00360815 NCT00360893.

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

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Diabetes Complications* / complications
  • Diabetes Complications* / epidemiology
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetes Mellitus, Type 1* / therapy
  • Humans
  • Oral Health
  • Risk Factors
  • Tooth Loss* / complications

Associated data

  • ClinicalTrials.gov/NCT00360815
  • ClinicalTrials.gov/NCT00360893