Advancing Dental-Medical Integration: Plans, Providers, and Patients.

Recent studies from Mayo Clinic, DentaQuest Foundation, and many others have further reinforced that preventative oral healthcare and the treatment of periodontal disease improves overall wellness and lowers the total cost of care. Patients benefiting the most are those with diabetes, cardiovascular disease, or other chronic conditions. Given the prevalence and growth of these high-risk conditions, and with nearly half of Americans suffering from periodontal disease, the industry has begun to act.

Advancing oral health policy through persuasive messaging and effective research measures.

Oral health is often excluded from broad health policy discussions, addressed only in a policy silo. There is a paucity of research to guide policymaking as it relates to oral health. In response, AcademyHealth's Oral Health Interest Group organized a meeting during the 2019 AcademyHealth Annual Research Meeting to promote transdisciplinary dialog on the current state of oral health policy and the steps necessary to improve the oral health of Americans. This article summarizes the two main themes that emerged from the proceedings of the Oral Health Interest Group meeting: a) recommendations for advocating the inclusion of oral health in policy discussions and b) critical research topics and measures needed for effective oral health policies in the future.

History of periodontal treatment and risk for intrauterine growth restriction (IUGR).

BACKGROUND: To explore the hypothesis that maternal periodontitis is associated with increased risk for Intrauterine Growth Restriction (IUGR), we examined the risk of IUGR in relation to periodontal treatment before, during and after pregnancy. METHODS: We conducted a retrospective cohort analysis of insurance claims data from 2009 to 2012 for women who delivered a singleton live birth (n = 32,168). IUGR was examined as a function of type and timing of dental treatment, adjusting for potential confounders in logistic regression. Sensitivity analysis evaluated the potential effects of unmeasured confounding. RESULTS: Women who received periodontal treatment after delivery, indicating the presence of untreated periodontal disease during pregnancy, had significantly higher odds of IUGR compared to women who received no periodontal treatment (adjusted OR 1.5, 95% CI 1.2, 1.8). CONCLUSIONS: Periodontal treatment provided in the immediate postpartum period, a proxy for periodontitis during gestation, was associated with increased risk of IUGR.

An examination of periodontal treatment, dental care, and pregnancy outcomes in an insured population in the United States.

OBJECTIVES: We examined whether periodontal treatment or other dental care is associated with adverse birth outcomes within a medical and dental insurance database. METHODS: In a retrospective cohort study, we examined the records of 23,441 women enrolled in a national insurance plan who delivered live births from singleton pregnancies in the United States between January 1, 2003, and September 30, 2006, for adverse birth outcomes on the basis of dental treatment received. We compared rates of low birthweight and preterm birth among 5 groups, specifying the relative timing and type of dental treatment received. We used logistic regression analysis to compare outcome rates across treatment groups while adjusting for duration of continuous dental coverage, maternal age, pregnancy complications, neighborhood-level income, and race/ethnicity. RESULTS: Analyses showed that women who received preventive dental care had better birth outcomes than did those who received no treatment (P < .001). We observed no evidence of increased odds of adverse birth outcomes from dental or periodontal treatment. CONCLUSIONS: For women with medical and dental insurance, preventive care is associated with a lower incidence of adverse birth outcomes.