THE MOUTH: The Missing Piece to Overall Wellness and Lower Medical Costs

This research was originally published in 2014 .

We have curated this article as a reference point for The Larkin Protocol.

Executive Summary

Chronic medical conditions are a widespread issue, affecting an estimated one out of every two adults over 21. And, periodontitis, also known as gum disease, is an epidemic of its own with 47% of Americans having the disease at any one time.

To understand if there’s a connection between the two, United Concordia pursued original research conducted by Dr. Marjorie Jeffcoat, Professor of Periodontology and Dean Emeritus at the University of Pennsylvania School Of Dentistry. The study, published in a peer-reviewed medical journal, was conducted on a comprehensive, five-year data set in collaboration with our parent company, Highmark Health, Inc. and evaluated the impact of gum disease treatment on medical costs and hospitalizations for members with certain chronic medical conditions and women who were pregnant. Using medical claims data from Highmark and United Concordia dental plans, nearly 1.7 million insurance records from 2005–2009 were analyzed. Of that data set, 338,891 members were identified with both medical and dental insurance. Data subsets were created by including those with 1) a diagnosis of at least a specified medical condition and 2) evidence of periodontal disease. Chronic conditions included: cerebral vascular disease (stroke), coronary artery (heart) disease, and type 2 diabetes. Also, included in the study were women who were pregnant during this same time period.

Type 2 diabetes was a covariant in this study, meaning that its effect on the outcome, if any, was accounted for when inspecting the results of these other diseases. The study compared members who completed treatment and maintenance for gum disease and those who didn’t. For each treatment group of each medical condition, two outcomes were analyzed: 1) total annual medical costs and 2) total annual number of hospitalizations. 1 THE MOUTH The Missing Piece to Overall Wellness and Lower Medical Costs The results of this study were presented by Dr. Jeffcoat at the American Association of Dental Research meeting in Charlotte, NC on March 21, 2014 and included data on the average annual medical cost savings and reduction in hospitalizations for those who completed periodontal treatment and maintenance versus those who did not. These results were impressive:

Annual Medical Costs Savings

$5,681 for members with cerebral vascular disease (stroke)

$1,090 for members with coronary artery disease (heart)

$2,840 for members with diabetes ($1,477 for diabetes outpatient drug costs*)

$2,433 for women who were pregnant

*Internal Jeffcoat data analysis on diabetes and drug costs. Average savings after seven or more periodontal visits

Annual Hospitalization Reductions**

21.2% for members with stroke

28.6% for members with heart disease

39.4% for members with diabetes

**Not applicable for women who were pregnant.

This study showed overall that annual medical costs and hospitalizations were considerably lower for members with chronic medical conditions and women who were pregnant who completed their periodontal treatment and maintenance. When people treated oral health as a key piece of wellness, their overall health care costs and hospital admissions went down across all these condition categories. And, the opportunity for cost savings is significant. Routine oral care helps prevent and respond to problems early before they develop into complex and more expensive ones. Without a doubt, good oral health is critical to overall health. The right dental coverage makes it easy for members to get the care they need to improve their overall wellness. At United Concordia, we are looking to do that.


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