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Study examines effect of periodontal treatment on health care costs

January 27, 2016

By Jennifer Garvin

A new ADA Health Policy Institute study finds a “statistically significant association” between periodontal intervention and lower health care costs among people newly diagnosed with diabetes.

In an article published Jan. 22 online in the highly regarded journal Health Economics, ADA health economists Kamyar Nasseh, Ph.D., and Marko Vujicic, Ph.D., examined whether patients who received periodontal intervention after being diagnosed with Type 2 diabetes had lower overall health care costs in subsequent years compared to those patients who did not receive periodontal treatment.

The authors found that among those individuals newly diagnosed with Type 2 diabetes, a periodontal intervention was associated with a $1,799 average reduction in total health care costs over two years. Interestingly, for those patients who initiated medication to manage their diabetes, there were no cost savings associated with periodontal treatment.

“This is not the first study to examine the relationship between dental care use and health care costs,” said Dr. Nasseh, ADA health economist. “What is novel however, is that we use a very large multipayer claims database and we use econometric techniques to control for confounding factors.”

“The health care landscape is shifting dramatically in the U.S. and the dental care sector is part of this,” added Dr. Vujicic, chief economist and vice president of the ADA Health Policy Institute. “With health care moving toward integrated models with much more provider collaboration, we knew it was important to shed light on the benefits of oral health beyond the mouth.” 

The authors evaluated the data from more than 15,000 adults ages 18-64 newly diagnosed with Type 2 diabetes. They then divided the patient data into two groups: initiators of periodontal therapy and non-initiators of periodontal therapy, and examined total health care costs over a two-year period for both groups, controlling for other factors.

The authors noted that the study contained a number of limitations, chiefly, that because the use of diagnostic coding is not widespread in dentistry, they couldn’t identify periodontal disease status of the patients.

“Ideally, we would select patients with Type 2 diabetes and periodontitis and split them into treatment and control groups depending on whether they received a periodontal intervention,” wrote Drs. Nasseh and Vujicic. “Unfortunately, we can only identify whether a person newly diagnosed with Type 2 diabetes had a periodontal visit, which is identified using CDT codes. As a result, we expect that some portion of newly diagnosed individuals with Type 2 diabetes not receiving a periodontal intervention actually do not have periodontal disease. Among this subgroup, there is likely no medical cost savings associated with a periodontal intervention.”

The study, “The Relationship Between Periodontal Interventions and Healthcare Costs and Utilization. Evidence from an Integrated Dental, Medical, and Pharmacy Commercial Claims Database,” was coauthored by Dr. Michael Glick, editor of The Journal of the American Dental Association.

To read the article in full, click here. Note: Health Economics does charge a fee for accessing its content.