Oral Health Status and Most Prevalent Noncommunicable Diseases in US

Objectives: Poor health outcomes are associated with a number of oral health conditions, and in many cases share similar risk factors. The objective was to analyze the association of the four most prevalent noncommunicable diseases (NCDs) in the U.S. with key measures of Oral Health (OH) status in adults aged 40 and older.
Methods: Data from 7,148 participants in NHANES 2011-2014 were used. Key OH outcome variables were: (1) edentulism, (2) functional dentition (≥ 21 natural teeth), (3) moderate or severe periodontal disease, and (4) untreated caries. Four NCDs were analyzed as independent categorical variables (yes/no) derived from NHANES self-reported questionnaires inquiring about cancer, cardiovascular diseases (congestive heart failure, coronary heart disease, angina pectoris, heart attack, stroke), chronic respiratory disease (asthma, emphysema, chronic obstructive pulmonary disease, chronic bronchitis) and diabetes (pre-diabetes, diabetes, currently taking insulin). Covariate variables included age, race/ethnicity, sex, poverty level based on federal poverty guidelines, smoking status, and health insurance (private, public, none). Multivariable modelling and procedures to account for the complex survey design to produce weighted results was used.
Results: Approximately 15% of adults reported having cancer: 14% had cardiovascular diseases, 19% had chronic respiratory disease, and 19% had diabetes. Multivariable models indicate cancer was not associated with any OH measures; chronic respiratory disease was associated with edentulism (OR=1.42; 95% CI 1.10-1.84); cardiovascular disease was associated with edentulism (OR=2.04; 95% CI 1.45-2.87), functional dentition (OR=0.38; 95% CI 0.25-0.56), and untreated caries (OR=1.22; 95% CI 1.01-1.48); diabetes was associated with functional dentition (OR=0.77; 95% CI 0.60-0.99) and moderate or severe periodontal disease (OR=1.24; 95% CI 1.07-1.45). Smoking was associated with all 4 OH measures in all 4 main NCD models.
Conclusions: Overall, 3 of 4 most prevalent NCDs are associated with at least one key measure of OH status for adults in the US. In addition, smoking (a common risk factor for NCDs and OH) is a leading risk factor affecting overall health.