Oral health-related quality of life and diabetes outcomes: Evidence from a nationally representative U.S. sample

Background/purpose: The association between self-perceived oral health-related quality of life (OHRQoL) and objective diabetes outcomes is largely unknown. This study examined six domains in Locker's framework, focusing on poor OHRQoL associated with adverse diabetes outcomes-poor glycemic control, diabetes-related complications, and polypharmacy-among U.S. adults with diabetes. Materials and methods: Data were drawn from the 2021-2023 National Health and Nutrition Examination Survey. The sample included 1179 adults aged ≥20 with diagnosed or undiagnosed diabetes (HbA1c ≥ 6.5 %), representing approximately 30.2 million U.S. adults. Six survey questions (OHQ620-OHQ680) from the Oral Health Impact Profile (OHIP) were analyzed individually to reflect Locker's conceptual domains. Outcomes included HbA1c ≥ 8 %, diabetes-related complications, and polypharmacy (defined as ≥ 5 prescribed medications). Weighted logistic regressions estimated odds ratios (OR) controlling for sociodemographic and behavioral factors. Results: Poor ratings in the domains of handicap (OHQ630), social disability (OHQ640), and psychological discomfort (OHQ680) were associated with higher odds of adverse outcomes. Specifically, individuals with poor OHQ630 and OHQ640 had greater odds of poor glycemic control (range of OR = 1.637-2.644) and diabetes-related complications (range of OR = 2.220-2.262), and poor OHQ630 and OHQ680 had greater odds of having polypharmacy (range of OR = 1.697-2.225) compared with those without poor ratings. Conclusion: Self-perceived poor OHRQoL is associated with objective diabetes outcomes, highlighting the need for integrated medical-dental care for diabetes as a public health priority. Additionally, integrating OHIP screening into community outreach programs could help identify individuals at risk for diabetes and oral health problems, facilitating early interventions.