Laird Harrison

March 27, 2012

March 27, 2012 (Tampa, Florida) — Patients with diabetes who are treated for periodontal disease are less likely to see a physician and less likely to be hospitalized. Furthermore, they cost the healthcare system $1800 less per patient per year, researchers reported here at the American Association for Dental Research 2012 Annual Meeting.

"The biggest surprise was the tremendous decrease in doctor visits," lead investigator Marjorie Jeffcoat, DMD, professor of periodontics at the University of Pennsylvania, Philadelphia, told Medscape Medical News. "The doctors felt they did not need to see these patients."

Dr. Jeffcoat and her colleagues looked at data from patients who had Highmark medical insurance and United Concordia dental insurance. United Concordia, a subsidiary of Highmark, funded the study.

The researchers identified 91,454 patients with diabetes, making this study the largest in a series suggesting that periodontal care can improve the health of these patients.

From this group of diabetic patients, the investigators analyzed 773 patients who chose to have periodontal treatment and 60,706 who chose not to have periodontal treatment (control group). Both groups were covered by dental and medical insurance.

There was a 33% reduction in the number of hospitalizations with treatment; the mean number of hospitalizations was 5.9 in the treatment group and 9.0 in the control group (P < .02).

There was a 13% reduction in the number of physician visits with treatment; the mean number of visits was 16.4 in the treatment group and 19.0 in the control group (P < .0001).

There was a savings of $1814 (or 25%) with treatment; mean medical cost was $5522 in the treatment group and $7336 per year in the control group (P < .05).

"The other thing that was a big surprise was that the effect was maintained over a 3-year period," said Dr. Jeffcoat.

The savings in medical costs increased while the difference in doctor visits and hospitalizations diminished over the 3 years.

These findings might convince people to get dental care, session moderator Jeffrey Payne, DDS, associate dean for dental research at the University of Nebraska in Lincoln, told Medscape Medical News. "A number of people may not perceive dental treatment as elective, he said. "They may not see it as life-saving."

"I think it is fascinating work. If dental treatment can reduce medical costs, it is an opportunity to expand dental treatment," said Dr. Payne.

But the research does not definitely establish that periodontal treatment reduces the need for medical care in diabetics, he pointed out.

The same patients who chose periodontal care might have made other healthy choices that distinguished them from the control group, he said.

Dr. Jeffcoat said the insurance companies provided some information about lifestyle that her group hopes to analyze; however, the 2 groups were not different in measures of general health at the outset of the study, she explained.

A large number of the patients had other health conditions, such as cardiovascular disease. In the future, Dr. Jeffcoat and her colleagues hope to study the data on these patients to see whether a similar link can be found between periodontal treatment and these diseases.

Dr. Jeffcoat and Dr. Payne have disclosed no relevant financial relationships.

American Association for Dental Research (AADR) 2012 Annual Meeting: Abstract 753. Presented March 23, 2012.


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