Oral health-related quality of life in US adults with type 2 diabetes.

OBJECTIVES

The objective of this study was to analyze factors associated with oral health-related quality of life (OHRQoL) between type 2 diabetes mellitus (T2DM) and nondiabetic US adults.

METHODS

The study sample included 2945 participants (aged ≥20) selected from National Health and Nutrition Examination Survey (NHANES) 2003-2004 that represented 130,689,262 million persons in a probability weighted sample. Oral health outcomes were measured by the NHANES version of Oral Health Impact Profile (OHIP) for OHRQoL and summarized as additive scores (OHIP-ADD) and as prevalence of negative impacts (OHIP-SC). Multiple logistic regression models used dichotomous outcome variables OHIP-ADD and OHIP-SC. The cut-off values for poor OHRQoL were heuristically defined as OHIP-ADD ≥6 and as OHIP-SC > 0.

RESULTS

Poor OHRQoL was significantly (p < 0.0001) predicted by T2DM (OR  = 1.43, OR  = 1.73), obesity (OR  = 1.24), untreated dental caries (OR  = 1.79), periodontal disease (OR  = 1.07), evaluated unmet denture need (OR  = 1.72), low income (OR  = 1.22), smoking (OR  = 1.04, OR  = 1.99), African-American (OR  = 1.19), and female (OR  = 1.66) in both logistic regression models. In contrast, protective factors significantly (p < 0.0001) associated with poor OHRQoL were private dental insurance (OR  = 0.81), college education (OR  = 0.85), and annual dental prophylaxis (OR  = 0.83), after adjustment for covariates.

CONCLUSIONS

This study showed that private insurance coverage and annual prophylaxis are associated with better average OHRQoL among individuals with T2DM. Improved OHRQoL may be associated with glycaemia control, decreased BMI, and smoking cessation. The highest odds for poor OHRQoL were found among US adults with T2DM with uncontrolled HbA1c, untreated dental caries, and current smoking.