Is tooth loss associated with multiple chronic conditions?

Figures & data

Table 1. Distribution of all variables used in the analysis and mean number of multiple chronic conditions (MCC) among American adults aged 25–64, BRFSS 2018, N = 202,809.

Variables		Percentage (95% CI)	Mean MCC (95% CI)	p value*
Sex	Male	51.6 (51.1, 51.9)	0.74 (0.73, 0.76)	<.001
	Female	48.4 (48.0, 48.8)	0.99 (0.97, 1.00)
Age	25–34	25.9 (25.5, 26.3)	0.52 (0.51, 0.53)	Ref
	35–44	24.6 (24.2, 24.9)	0.65 (0.63, 0.67)	<.001
	45–54	24.5 (24.1, 24.8)	0.94 (0.92, 0.97)	<.001
	55–64	25.0 (24.6, 25.4)	1.34 (1.31, 1.36)	<.001
Race	White	62.7 (62.2, 63.1)	0.91 (0.89, 0.92)	Ref
	Black	12.2 (11.9, 12.5)	0.93 (0.90, 0.96)	.210
	Hispanic	17.1 (16.6, 17.5)	0.71 (0.68, 0.74)	<.001
	Others	8.0 (7.7, 8.3)	0.71 (0.68, 0.75)	<.001
Tooth loss	None	60.3 (59.8, 60.7)	0.63 (0.62, 0.64)	Ref
	1–5 teeth	29.1 (28.6, 29.4)	0.96 (0.94, 0.98)	<.001
	6 or more but not all	7.6 (7.4, 7.8)	1.75 (1.70, 1.81)	<.001
	All – edentulous	3.0 (2.8, 3.1)	2.17 (2.01, 2.24)	<.001
Education	<high school	11.3 (11.0, 11.7)	1.17 (1.12,1.22)	Ref
	High school	24.8 (24.3, 25.1)	0.94 (0.92, 0.96)	<.001
	Some collage	30.7 (30.2, 31.1)	0.95 (0.93, 0.97)	<.001
	Collage graduate	33.2 (32.8, 33.6)	0.61 (0.60, 0.62)	<.001
Annual income (US$)	<15,000	9.0 (8.7, 9.2)	1.63 (1.59, 1.68)	Ref
	15,000–<25,000	13.7 (13.4, 14.0)	1.22 (1.19, 1.25)	<.001
	25,000–<35,000	8.7 (8.4, 9.0)	0.94 (0.90, 0.97)	<.001
	35,000–<50,000	11.8 (11.5, 12.1)	0.82 (0.79, 0.85)	<.001
	50,000+	56.8 (56.3, 57.2)	0.65 (0.63, 0.66)	<.001
Health insurance	No	12.9 (12.5, 13.2)	0.74 (0.71, 0.77)	<.001
	Yes	87.1 (86.7, 87.4)	0.88 (0.87, 0.89)
Smoking	Never smoked	58.1 (57.6, 58.5)	0.67 (0.66, 0.68)	Ref
	Former smoker	23.2 (22.8, 23.6)	1.02 (1.00, 1.04)	<.001
	Current smoker	18.7 (18.3, 19.0)	1.25 (1.25, 1.28)	<.001
Physical activity	No	22.3 (21.9, 22.6)	1.26 (1.23, 1.28)	<.001
	Yes	77.7 (77.3, 78.1)	0.75 (0.74, 0.76)
BMI	Normal weight	29.8 (29.4, 30.2)	0.68 (0.66, 0.69)	Ref
	Overweight	35.7 (35.2, 36.1)	0.73 (0.71, 0.75)	<.001
	Obese	34.5 (34.1, 34.9)	1.15 (1.13, 1.17)	<.001
Mean number of multiple chronic conditions		0.86 (0.85, 0.87)

*p value for difference in mean of multiple chronic conditions.

Table 2. Percentages of participants with chronic conditions by number of missing teeth among American adults aged 25–64, BRFSS 2018, N = 202,809.

Chronic condition	Overall percentage (95% CI)	Percentages (95%CI) within number of missing teeth groups				Significance*
		None	1–5	6 or more, but not all	All-edentulous
Heart attack	3.2 (3.1, 3.4)	1.7 (1.5, 1.9)	4.1 (3.7, 4.6)	8.1 (7.4, 8.8)	13.9 (12.1, 15.9)	<.001
Angina or CHD^a	2.9 (2.8, 3.1)	1.5 (1.4, 1.7)	3.7 (3.3, 4.2)	7.7 (7.0, 8.4)	11.6 (10.0, 13.4)	<.001
Stroke	2.4 (2.3, 2.5)	1.3 (1.2, 1.4)	2.6 (2.3, 2.8)	7.5 (6.7, 8.4)	9.6 (8.5, 10.7)	<.001
Asthma	14.6 (14.3, 14.9)	13.5 (13.1, 13.9)	14.3 (13.7, 14.8)	20.7 (19.5, 21.9)	23.7 (21.9,25.5)	<.001
Cancer^b	4.7 (4.5, 4.9)	3.6 (3.4, 3.7)	5.2 (4.9, 5.5)	9.6 (8.6, 10.6)	11.1 (9.9, 12.3)	<.001
Pulmonary disease	5.6 (5.4, 5.8)	2.8 (2.6, 3.0)	5.9 (5.6, 6.3)	18.2 (17.1, 19.4)	28.2 (26.3, 30.1)	<.001
Arthritis	22.0 (21.6, 22.3)	15.7 (15.4, 16.1)	25.8 (25.1, 26.5)	45.5 (44.1, 47.0)	51.3 (49.1, 53.5)	<.001
Depression	19.7 (19.4, 20.1)	16.5 (16.1, 16.9)	20.9 (20.3, 21.6)	33.5 (32.1, 34.8)	39.8 (37.6, 41.9)	<.001
Diabetes	9.2 (9.0, 9.5)	5.7 (5.5, 6.0)	12.1 (11.5, 12.7)	20.4 (19.2, 21.7)	23.4 (21.7, 25.2)	<.001
Kidney disease	2.3 (2.2, 2.4)	1.5 (1.4, 1.7)	2.6 (2.4, 2.9)	5.6 (4.9, 6.4)	6.5 (5.6, 7.6)	<.001

*p value from Chi-Square.

^aAngina or coronary heart disease (CHD).

^bAny cancer.

Table 3. Results of negative binomial regression analysis showing rate ratios and 95% CI for factors associated with multiple chronic conditions (MCC) among American adults aged 25–64, BRFSS 2018, N = 202,809.

Variables		Rate Ratio for multiple chronic conditions (95% CI)
		Model 1	Model 2
Sex (Ref: male)		1.32*** (1.29, 1.35)	1.28*** (1.25, 1.31)
Age (Ref: 25–34)	35–44	1.16*** (1.12, 1.20)	1.18*** (1.14, 1.22)
	45–54	1.55*** (1.50, 1.60)	1.57*** (1.52, 1.63)
	55–64	1.98*** (1.91, 2.05)	2.00*** (1.93, 2.07)
Race (Ref: white)	Black	1.01 (0.97, 1.04)	0.88*** (0.85, 0.91)
	Hispanic	0.86*** (0.82, 0.89)	0.76*** (0.73, 0.79)
	Others	0.85*** (0.81, 0.89)	0.88*** (0.84, 0.93)
Tooth loss (Ref: none)	1–5 teeth	1.39*** (1.36, 1.43)	1.18*** (1.15, 1.21)
	6 or more but not all	2.25*** (2.17, 2.33)	1.53*** (1.48, 1.59)
	All – edentulous	2.65*** (2.55, 2.76)	1.62*** (1.55, 1.69)
Education (Ref: <high school)	High school		0.92** (0.89, 0.96)
	Some collage		1.07** (1.03, 1.12)
	Collage graduate		0.96 (0.91, 1.00)
Income (Ref: <15,000) (US$)	15,000–<25,000		0.83*** (0.80, 0.86)
	25,000–<35,000		0.69*** (0.66, 0.72)
	35,000–<50,000		0.60*** (0.57, 0.63)
	50,000+		0.50*** (0.48, 0.52)
Health insurance (Ref: no)			1.27*** (1.22, 1.32)
Smoking (Ref: never smoked)	Former smoker		1.28*** (1.25, 1.32)
	Current smoker		1.43*** (1.33, 1.48)
Physical activity (Ref: no)			0.84*** (0.82, 0.86)
BMI (Ref: normal weight)	Overweight		1.08*** (1.05, 1.11)
	Obese		1.53*** (1.49, 1.58)

Model 1 adjusted for age, sex, race and number of missing teeth.

Model 2 additionally adjusted for education, income, insurance, smoking, physical activity, and BMI.

*** p < 0.001, ** p < 0.01, * p < 0.05.