Abstract
OBJECTIVES: A bidirectional relationship between periodontitis and diabetes has been reported. Its mechanisms are yet to be elucidated. This study examines the interplays amongst dental conditions (periodontitis and functional dentition), diet, and glycaemic control of adults. METHODS: Relevant data of the NHANES surveys (2011-2012 and 2013-2014) (n = 6076) were extracted, including dental examination for generalised severe periodontitis (GSP) and functional dentition, laboratory tests for haemoglobin A1c (HbA1c), and 24-hour dietary recall. Multiple regressions and path analysis were conducted to assess the association between dental conditions and glycaemic control and the mediation effect of diet. RESULTS: Higher HbA1c value was associated with GSP (coef: 0.34; 95% CI: 0.10 to 0.58) and nonfunctional dentition (coef: 0.12; 95% CI: 0.01 to 0.24). Associations were also found between lower fibre intake (g/1000 kcal) with GSP (coef: -1.16; 95% CI: -1.61 to -0.72) and nonfunctional dentition (coef: -0.80; 95% CI: -1.18 to -0.42). Mediation effect of diet (% energy from carbohydrate and energy-adjusted fibre intake) for the association between dental conditions and glycaemic control was not significant. CONCLUSIONS: Periodontitis and functional dentition are significantly associated with fibre intake and glycaemic control in adults. Dietary intake, however, does not mediate the association between dental conditions and glycaemic control.