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Glycemic control and number of natural teeth: analysis of cross-sectional Japanese employment-based dental insurance claims and medical check-up data

Abstract

Aim

Diabetes mellitus is a well-known risk factor for onset and progression of periodontal disease. However, the continuous relationship between glycemic control and the number of natural teeth has not been well characterized in large-scale studies. We aimed to determine whether the glycated hemoglobin A1c (HbA1c) level and fasting plasma glucose (FPG) are associated with the number of natural teeth.

Methods

A cross-sectional study: A database comprising employment-based health insurance claim and medical check-up data from 706,150 participants between April 2015 and March 2016 in Japan. The exclusion criteria included missing data regarding dental receipts, number of natural teeth, HbA1c, smoking status, and age < 20 years. Ultimately, 233,567 individuals were analyzed. The participants were allocated to five groups according to their HbA1c and three groups according to their FPG, and then the number of natural teeth were compared.

Results

Higher HbA1c was associated with fewer teeth in participants ≥ 30 years of age (P for trend < 0.001). Higher FPG was associated with fewer teeth between 30 and 69 years of age (P for trend < 0.001). Participants with impaired fasting glucose was already at risk for fewer teeth between 40 and 69 years of age than those with normal FPG.

Conclusions

Glycemic control is strongly associated with the number of natural teeth in the real-world setting. Furthermore, there are continuous relationships of HbA1c and FPG with number of natural teeth including individual with impaired fasting glucose. These data emphasize the importance of glycemic control and appropriate oral care for the protection against tooth loss.

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Acknowledgements

The authors thank Dr. Satoshi Shizukuishi, and Dr. Midori Tsuneishi for their expert technical assistance. We also thank Mark Cleasby, PhD from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing the English text of drafts of this manuscript.

Funding

This work was funded by Sunstar Inc, Japan.

Author information

Affiliations

Authors

Contributions

KH and KM conceived and designed the study. KM takes responsibility for the integrity of the data and the accuracy of the data analysis. KH, MI, IM and TY performed the statistical analysis. HM and AI supervised the study. All authors reviewed, edited, and approved the final manuscript.

Corresponding author

Correspondence to Katsutaro Morino.

Ethics declarations

Conflicts of interest

KH, MI, TY, MH and AI are employees of Sunstar Inc. The authors participated in the preparation, analysis and interpretation of the data. HM received research support unrelated to this study from Astellas Pharma Inc., AstraZeneca K.K., Bayer, Daiichi Sankyo, Eli Lilly Japan, Kowa Pharmaceutical, Kyowa Hakko Kirin, Miki Corporation, Mitsubishi Tanabe Pharma, MSD, Nippon Boehringer Ingelheim, Nipro, Nissan Chemical Corporation, Novartis, Novo Nordisk Pharma, Ono Pharmaceutical, Sanofi, Sumitomo Dainippon Pharma, Taisho Toyama Pharmaceutical, Takeda Pharmaceutical, Sanwa Chemical, Shionogi and Teijin Pharma; and lecture fees and fees for serving on advisory boards from AstraZeneca K.K., Daiichi Sankyo, Eli Lilly Japan, Mitsubishi Tanabe Pharma, MSD, Nippon Boehringer Ingelheim, Novo Nordisk Pharma, Sanofi, Sumitomo Dainippon Pharma and Takeda Pharmaceutical. KM received grants from Astellas, AstraZeneca, Ono Pharmaceutics and Sanwa Kagaku Kenkyusho that were unrelated to this study. No other potential conflicts of interest relevant to this study are declared.

Ethics approval

As secondary database we used for research purposes contained anonymized data only, this article does not contain any studies with human or animal subjects performed by any of the authors. Patient informed consent was not required, because it is impossible to link the identifiers with external information.

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Harada, K., Morino, K., Ishikawa, M. et al. Glycemic control and number of natural teeth: analysis of cross-sectional Japanese employment-based dental insurance claims and medical check-up data. Diabetol Int (2021). https://doi.org/10.1007/s13340-021-00533-2

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Keywords

  • Epidemiology
  • Diabetes mellitus
  • Impaired fasting glucose
  • Tooth loss
  • Smoking