Association among the number of natural teeth, dental maintenance visits and diabetes status: a cross-sectional study using employment-based healthcare claims database

Miki Ishikawa; Takako Yasuda; Natsuki Nara; Itsuko Miyazawa; Naoko Takase; Kayo Harada; Atsushi Ishikado; Katsutaro Morino

doi:10.1007/s13340-025-00805-1

Association among the number of natural teeth, dental maintenance visits and diabetes status: a cross-sectional study using employment-based healthcare claims database

Diabetol Int. 2025 Feb 20;16(2):403-413. doi: 10.1007/s13340-025-00805-1. eCollection 2025 Apr.

Authors

Miki Ishikawa¹, Takako Yasuda¹, Natsuki Nara², Itsuko Miyazawa³, Naoko Takase⁴, Kayo Harada¹, Atsushi Ishikado^{1

3}, Katsutaro Morino^{3

5}

Affiliations

¹ R&D Department, Sunstar Inc., Takatsuki, Osaka Japan.
² MinaCare Co., Ltd., Chiyoda-Ku, Tokyo, Japan.
³ Department of Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga 520-2192 Japan.
⁴ Sunstar Foundation, Takatsuki, Osaka Japan.
⁵ Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima Japan.

Abstract

Aim: Although diabetes is associated with the risk of tooth loss, there are no large-scale studies examining the reality and the effectiveness of dental maintenance visits in preventing tooth loss. We aimed to investigate the associations among the number of teeth, dental maintenance visits and diabetic status.

Methods: This is a cross-sectional study: a database comprising employment-based health insurance claim and medical check-up data between April 2015 and March 2016. From the dental receipts for a total of 705,542 individuals aged 20-74 years, we calculated dental visits ratio. After excluding missing data on the number of teeth and HbA1c, the association between dental maintenance visits and the number of teeth was further examined in 185,820 individuals aged 40-69 years visited a dentist by diabetes status.

Results: The percentage of dental visits was 46% overall, particularly low among younger subjects (34% in 20 s, 43% in 30 s), and increased with age. The maintenance-included group had a higher number of teeth than the treatment-only group, even at older ages, and this association was observed regardless of diabetes or glycemic control status. Furthermore, even with diabetes, the number of teeth in the group with good glycemic control was like that of non-diabetic.

Conclusion: Dental visits ratio was particularly low among younger subjects and those who receive dental maintenance had a higher number of teeth, regardless of diabetes or not. Adequate glycemic control and dental maintenance were associated with the number of teeth in the people with diabetes. The results suggest that it is important for physicians to work closely with dentists to promote patient-centered care and encourage both maintenance visits and better glycemic control.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-025-00805-1.

Keywords: Dental maintenance visit; Epidemiology; Glycemic control; Tooth loss.

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