Chronic Conditions, Multimorbidity and Their Associations With Tooth Loss, Dental Caries and Periodontal Disease: An Australian Perspective.

INTRODUCTION: There is a paucity of nationwide population-based studies exploring the associations between chronic conditions and oral health. This study was conducted to describe the sociodemographic characteristics of a sample of Australian dentate adults with chronic conditions and to ascertain the associations of chronic conditions with tooth loss, dental caries and periodontal disease. METHODS: Data were drawn from the National Study of Adult Oral Health (NSAOH) 2017-18, which included a random sample of Australians aged 15+ years. NSAOH used online/telephone interviews to elicit self-reported information, including sociodemographic characteristics, and oral examinations to collect clinical data. Information on chronic conditions was collected in the pre-examination questionnaire. Clinical information was ascertained in 5022 dentate adults. A 95% confidence interval (95% CI) was considered for proportions and means calculations. RESULTS: While age was strongly associated with chronic conditions, their distribution showed a social gradient linked to education and income. Individuals with chronic obstructive pulmonary disease (COPD) (mean number of missing teeth = 11.5 [95% CI = 8.3, 14.7]) and kidney disease (mean number of missing teeth = 11.3 [95% CI = 8.5, 14.1]) had higher tooth loss whereas dental caries experience was higher in people with heart disease (mean number of decayed tooth surfaces [DS] = 2.5 [95% CI = 1.2, 3.7]) and depression (mean number of DS = 2.3 [95% CI = 1.4, 3.3]). Gingivitis was more prevalent in individuals with diabetes (40.1% [95% CI = 31.5, 49.4]) and high blood pressure (33.9% [95% CI = 29.3, 38.9]) while adults with heart disease (59.1% [95% CI = 39.3, 76.3]) and cancer (56.7% [95% CI = 43.2, 69.3]) had higher levels of periodontitis. Individuals with multimorbidity (presence of two or more concurrent chronic conditions) experienced greater tooth loss, dental caries and periodontitis. CONCLUSIONS: Australian dentate adults-particularly those with multimorbidity-exhibit significantly worse oral health statuses than healthy counterparts. These findings highlight the critical need to integrate oral care into general health services and implement targeted dental programmes for populations with chronic illnesses.