The association between diabetes mellitus, sugar-sweetened beverages, and tooth loss in adults: Evidence from 18 states

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Background—Sugar sweetened beverages (SSB) are dietary sources of sugar, factors in caries development and tooth loss. Dietary sugar is also linked to diabetes mellitus (DM). There is limited research with SSB and tooth loss in individuals with DM. The purpose of this study is to investigate the association between SSB and tooth loss by the presence or absence of DM. Methods—A cross-sectional design with data on adults (>18 years) from Behavior Risk Factor Surveillance System, 2012 of 18 states was used (n =95,897; 40,413 with DM and 81,854 without DM). Chi square, and logistic regression analyses by DM status were conducted. Results—Overall, 12.3% had DM; 15.5% had ≥6 teeth removed; and 22.6% reporting drinking ≥ 1 SSB daily. In adjusted analyses, among adults with DM, ≥ 2 SSB daily were more likely to have ≥ 6 teeth removed than adults reporting no SSB use (Adjusted odds ratio, AOR, = 2.35; 95% CI: 1.37, 4.01, P= 0.0018). Among adults without DM, those drinking >0 to < 0.0001). Conclusion—Among adults with DM, ≥2 SSB/day were associated with ≥ 6 teeth removed. Practical Implication—Dietary sugar is a concern for oral and systemic health; however, a strong, independent relationship between teeth removed and one, single source of dietary sugar is not adequate to explain the complexity of tooth loss and dietary messages should be broad when caries assessment is discussed.