title: Association of diabetes with tooth loss in Hispanic/Latino adults: findings from the Hispanic Community Health Study/Study of Latinos.
abstract: OBJECTIVE
  To investigate the association between diabetes mellitus and missing teeth in Hispanic/Latino adults from diverse heritage groups who reside in the USA.
  
  
  METHODS
  The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multicenter, population-based study of 18-74 years old who underwent a physical and oral examination (n=15 945). Glycemic status was categorized as diabetes, impaired, or normal, based on medication use, and American Diabetes Association criteria for fasting glucose and glycosylated hemoglobin (HbA1c). HbA1c<7% indicated good glycemic control, and HbA1c>7% indicated uncontrolled diabetes. We estimated ORs and 95% CIs for missing >9 teeth and being edentulous (missing all natural teeth), after adjustment for age, income, education, Hispanic background, study site/center, nativity, last dental visit, health insurance, diet quality, cigarette smoking, obesity, periodontitis, and C reactive protein.
  
  
  RESULTS
  Persons with uncontrolled diabetes had a significant increased likelihood of missing >9 teeth and being edentulous as compared with persons with normal glycemic status (adjusted OR=1.92, 95% CI 1.44 to 2.55 and adjusted OR=1.73, 95% CI 1.22 to 2.46, respectively). The association appeared to be stronger at younger ages (18-44 years old; p for interaction <0.0001). However, we found no associations of either impaired glycemia or controlled diabetes with tooth loss in adjusted models.
  
  
  CONCLUSIONS
  Dentists should be aware of their Hispanic patients' diabetes status and whether or not they are well controlled, because these may affect tooth loss and impair oral function, which can lead to poor nutrition and complications of diabetes.
authors.affiliation: Jacobi Medical Center, Bronx, New York, USA; New York University College of Dentistry, New York, New York, USA.
authors.forename: Ariel P
authors.initials: AP
authors.lastname: Greenblatt
authors.affiliation: Albert Einstein College of Medicine , Bronx, New York , USA.
authors.forename: Christian R
authors.initials: CR
authors.lastname: Salazar
authors.affiliation: New York University College of Dentistry , New York, New York , USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Northridge
authors.affiliation: Albert Einstein College of Medicine , Bronx, New York , USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kaplan
authors.affiliation: University of California San Francisco School of Dentistry , San Francisco, California , USA.
authors.forename: George W
authors.initials: GW
authors.lastname: Taylor
authors.affiliation: Graduate School of Public Health, San Diego State University , San Diego, California , USA.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Finlayson
authors.affiliation: Albert Einstein College of Medicine , Bronx, New York , USA.
authors.forename: Qibin
authors.initials: Q
authors.lastname: Qi
authors.affiliation: Jacobi Medical Center, Bronx, New York, USA; Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Badner
keywords: Adult Diabetes; Hispanics; Oral and Systemic Health