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 “We were very surprised at the magnitude of the results,” Dr.
Marjorie Jeffcoat told Reuters Health. She led the study at the
University of Pennsylvania School of Dental Medicine in
Philadelphia.
Periodontal disease is a chronic inflammatory condition caused by
bacteria that coat the surface of the roots of the teeth. If not
treated, it can lead to bone loss around the teeth, infection and
tooth loss.
Treatment consists of cleaning the teeth above and below the gum
line. In advanced cases, surgery is required.
Jeffcoat said a number of previous small studies hinted that
treating periodontal disease may help improve other medical
conditions as well and reduce the risk of premature birth among
pregnant women.
To learn more, she and her colleagues analyzed claims from two
Pennsylvania insurance companies to determine if costs were lower
over time for patients who had their gum disease treated.
“We wanted to see if it pays from a financial point of view, to
treat the disease,” Jeffcoat said.
For their records to be included in the study, patients had to have
been enrolled in both the dental and medical plans for at least one
year and have been seen at least once for periodontal disease. They
also had to have a diagnosis of type 2 diabetes, coronary artery
disease, stroke or rheumatoid arthritis, or have been pregnant.
Treated patients were counted as those who had several follow-up
appointments for gum disease coded in their records.
Records for 338,891 patients were included.
The study team found significant reductions in both healthcare costs
and hospital stays over a period of five years among treated
patients with each of the conditions except rheumatoid arthritis.
On average, non-dental healthcare costs for people with diabetes or
stroke were about 40 percent lower if their gum disease was treated.
For those with coronary artery disease, costs were about 11 percent
lower with treatment.
Women who were pregnant and treated for gum disease had medical
costs that were 74 percent lower than those with untreated gum
disease, according to findings published in the American Journal of
Preventive Medicine.
When gum disease was treated, hospital admissions were also 39
percent lower among people with diabetes, 21 percent lower for
stroke patients and 29 percent lower for those with coronary artery
disease.
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Ryan Demmer, who has studied periodontal disease at the Columbia
University Mailman School of Public Health in New York, said it’s
plausible that microbes in the mouth can cause problems elsewhere in
the body, but more research is needed because studies have shown
mixed results.
Demmer, who was not involved with the new study, said it was a
creative and innovative way to address the question using existing
data from insurance records.
“But what they’re really getting at here is did treating the oral
infections reduce these types of outcomes or adverse events among
people with particular (other diseases),” he said, “and I think we
need more data from clinical trials that can fundamentally answer
that question.”
The authors agree that their study doesn’t prove treating gum
disease improved other conditions. For instance, it’s possible that
people who elected to have their gum disease treated also took
better care of themselves in general.
But Jeffcoat believes the findings are strong enough to recommend
that doctors have their patients checked for periodontal disease.
“Absolutely people should be checked - that's why we published this
paper in the American Journal of Preventive Medicine,” she said. “We
didn't publish in a dental journal because we wanted physicians to
see it so they could give good advice to their patients.”
Screening for periodontal disease is an easy procedure, Jeffcoat
added.
“Checking someone for periodontal disease can take as little as
three to five minutes,” she said.
SOURCE: http://bit.ly/1jQyEnk American Journal of Preventive
Medicine, online June 18, 2014.
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