We all know the reasons for going to the dentist regularly:
- Early detection (cavities, gum disease, oral cancer, bruxism)
- Checking existing fillings for structural weakness or peripheral decay
- Review of oral health practices
These are dental reasons, but there are other reasons as well.
The relationship between dental health and other medical health is not a new concept, with studies going back to the 1980’s. For example, the statistical relationship between heart attacks and poor dental health was noted in a 1989 Finnish study.
Managed care organizations have a strong financial incentive to lower health care costs. Healthier members have lower medical costs, so improving the health of members is an attractive alternative to cutting benefits in order to lower costs.
Aetna has been a leader in “Dental-Medical Integration” (DMI) as an approach to that end.
A study in 2006 found significant relationships between treatment for gum disease ( a proxy for having gum disease) and higher medical costs for cardiovascular, cerebrovascular, and diabetic conditions, heart, stroke, and diabetes, respectively.
In 2009, Aetna reported considerable success in getting dental care for at risk members:
In 2008, nearly 67,000 medically at-risk members sought dental care after being enrolled in Aetna’s Dental Medical Integration program. At-risk members are identified as those with diabetes, heart disease and pregnant women who have not seen a dentist in 12 months or more.
A 2011 University of Pennsylvania study in collaboration with Cigna Dental established lower medical costs two years after periodontal (gum) treatment:
Earlier this month Aetna reported:
- Lowered their medical claim costs by an average of 17 percent
- Improved diabetes control by 45 percent
- Used 42 percent less major and basic dental services
- Required 3.5 percent fewer hospital admissions year-over-year compared to a 5.4 percent increase for non-members
With the caveat that the Aetna programmed targeted individuals with particular diagnoses who had not seen a dentist in a year, we are nonetheless facing an important question:
Is it time to end the division between dental and medical insurance, treating health care for the mouth as a medical specialty like others, and dentists as medical specialists like others?
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