Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions.

BACKGROUND: Treatment of periodontal (gum) disease may lessen the adverse consequences of some chronic systemic conditions. PURPOSE: To estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes (T2D); coronary artery disease (CAD); cerebral vascular disease (CVD); rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study. METHODS: Insurance claims data from 338,891 individuals with both medical and dental insurance coverage were analyzed in 2011-2013. Inclusion criteria were (1) a diagnosis of at least one of the five specified systemic conditions and (2) evidence of periodontal disease. Subjects were categorized according to whether they had completed treatment for periodontal disease in the baseline year, 2005. Outcomes were (1) total allowed medical costs and (2) number of hospitalizations, per subscriber per year, in 2005-2009. Except in the case of pregnancy, outcomes were aggregated without regard to reported cause. Individuals who were treated and untreated for periodontal disease were compared independently for the two outcomes and five systemic conditions using ANCOVA; age, gender, and T2D status were covariates. RESULTS: Statistically significant reductions in both outcomes (p<0.05) were found for T2D, CVD, CAD, and pregnancy, for which costs were lower by 40.2%, 40.9%, 10.7%, and 73.7%, respectively; results for hospital admissions were comparable. No treatment effect was observed in the RA cohorts. CONCLUSIONS: These cost-based results provide new, independent, and potentially valuable evidence that simple, noninvasive periodontal therapy may improve health outcomes in pregnancy and other systemic conditions.

Potential future elements of dental care financing--a third-party payer's perspective.

The future of dental care financing may take on many changes in the future. These changes will likely have a dramatic affect on how dental care is delivered, reported and paid. Consumers and purchasers are keenly focused on price. In addition, areas of key focus in the dental benefits industry will be compensation, metrics and wellness initiatives, which will likely lead to high levels of transparency, accountability and development of the capability to report measurable outcomes.

Leadership: a new look, a new time, and established leadership.

The executive director of the American Dental Association characterizes leadership as involving inspiration, vision, and hope in the service of change. The need is great and the opportunities of numerous. Leadership has been built at the ADA through identifying a shared set of core values and through a billion dollar national Campaign for Dental Education. Although the future of the profession is bright, the outstanding leadership challenges include: increasing access, the cost and faculty shortages in dental education, globalization, emerging biotechnology, licensure, increasing the public's perceived value of oral health, and workforce matters.