More Disparities in Diabetes: African Americans More Likely to Lose Teeth

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Results come the same week that CDC announced a drop in new cases of diabetes that was confined to white, well-educated Americans.

A new study from Duke University is the second this week to offer good news and bad news relative to diabetes: while tooth loss among adults has slowed over 40 years, it is higher among those with the disease, and higher still among African Americans.

The findings, published Thursday in Preventing Chronic Disease, are based on data from 37,000 people who took part in the National Health and Nutrition Examination Surveys from 1971 to 2012.

The results come days after the CDC announced that new cases of diabetes had dropped for the first time in 25 years, from 1.7 million in 2008 to 1.4 million in 2014. But that news, too, came with a caveat: the drop came among white, well-educated Americans. New cases remain high among minorities and the poor.


Rates of diabetes and obesity remain high among African Americans, and the connections among diabetes, poor diet, and tooth loss was evident in the study published Thursday. Tooth loss is associated with diets that low in fiber, fruits, and vegetables; and high in foots heavy in cholesterol and saturated fats—exactly the opposite of what is recommended for those with diabetes.

According to the authors, “increasing evidence suggests a relationship between oral health and other chronic diseases, including cardiovascular disease, respiratory diseases, and cognitive decline.” Thus, maintaining teeth is not merely a cosmetic issue—it is tied to overall health.

Researchers found a significant decreasing trend in the number of teeth lost among all adults with diabetes over the period studied. However, adults with diabetes lost about twice as many teeth as those without the disease. In 1999-2000, for example, persons with diabetes were 34% less likely to have at least 21 teeth than those without the disease.

And, the number of teeth among African Americans with diabetes increased more with age than among whites with diabetes, or Mexican Americans with the disease.

The authors noted that among the oldest African Americans, lack of access to dental care in their youth likely led to a lack of knowledge about good dental hygiene, which accounted for how the number of teeth lost diverged after age 60. They noted that most adults with diabetes have poor oral hygiene. “Our study findings highlight the need to improve dental self-care and knowledge of diabetes risks among people with diabetes, especially non-Hispanic blacks, who had more tooth loss and lost teeth at a higher rate.”


Luo H, Pan W, Sloan F, Feinglos M, Wu B. Forty-year trends in tooth loss among American adults with and without diabetes mellitus: and age-period cohort analysis. Prev Chronic Dis. 2015;12:150309.