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The association between diabetes mellitus (DM) and the Decayed, Missing, Filled Teeth (DMFT) index is not yet settled. This study aimed to assess associations between DM and the DMFT index among adults in Central Sudan. A community-based cross-sectional study was conducted among adults (aged ≥ 18 years) in Central Sudan using a multistage stratified random sampling design. Dental morbidity was assessed using the DMFT index as a continuous dependent variable. Modified multivariate Poisson regression was used to calculate Adjusted Relative Risks (ARR) for associated factors. Seven hundred and seventy-three adults were enrolled. The median (interquartile range, IQR) DMFT index was 5 (2-10), and 14.6% of participants had DM. After adjustment, older age, lower education, and unemployment were significantly associated with the DMFT index. DM was associated with the DMFT index (ARR = 1.18, 95% CI = 1.10-1.26). Glycated (HbA1c) levels were also independently associated with increased DMFT index (ARR = 1.03, 95% CI = 1.02-1.04). DM is associated with DMFT index among adults in Central Sudan. There is a need to integrate oral and systemic health initiatives in Sudan.