Dental caries and diabetes in the elderly population in San Juan, Puerto Rico

People 65 years or older constitute 11.2% of the population in Puerto Rico, where the prevalence of diabetes is 28.7%. It has been hypothesized that diabetes could be a risk factor for caries due to increased glucose in saliva, increased glucose in gingival cervical fluid, decreased salivary flow and frequent intervals of food ingestion. This cross-sectional study compared the caries distribution among non-institutionalized adults ≥ 70 years, with and without diabetes, using a Poisson regression model. Participants were selected from a large representative sample of the Puerto Rican Elderly Health Conditions Study. Our study group included 184 individuals who underwent a comprehensive oral exam, where decayed, missing, and filled surfaces (DMFS) were assessed. When comparing mean DMFS index, people with diabetes had less filled surfaces (10.5 vs. 17.0; p<0.05) and more missing surfaces (63.0 vs. 54.2; p=0.06). No differences were found in root caries and root restorations across diabetes status (p>0.05). Due to interaction effects in the Poisson regression model for filled surface index, the analysis was stratified by BMI category. Among participants with BMI<25 kg/m2, diabetes was associated with less filled surfaces (adjusted RR=0.36, p<0.05), when adjusted for income and alcohol consumption; however, no statistical association (p>0.05) was observed among those with BMI≥25 kg/m2. Diabetes was also associated with more missing surfaces (adjusted RR=1.18; 0.05