Does a periodontal dental treatment after diagnosis of diabetes lead to lower healthcare costs and utilization in later years among a commercially insured population?

Objective. Published literature has shown a bi-directional relationship between periodontal disease and diabetes severity. We seek to determine whether periodontal treatment after initial diagnosis of diabetes leads to better healthcare outcomes. Among a commercially insured population of newly diagnosed diabetics recruited during calendar year 2006, we determine whether a periodontal visit any time in the first two years after diagnosis lead to lower healthcare resource utilization and costs in years three and four after initial diagnosis.

Data. 2005-2010 Truven Health MarketScan® Research Databases; American Community Survey.

Study Design. We used a propensity score to match users (treatment group) of periodontal services and non-users (control group) of periodontal services in the two years following initial diagnosis. We matched on age, gender, Charlson co-morbidity score, rural/urban status, U.S. census region, use of outpatient physician services before diagnosis, and use of dental services before diagnosis in addition to county level characteristics (median income, race/ethnic distribution, poverty rate and level of education). A gamma regression model was used to assess differences in healthcare costs between treatment and control groups. Logit models were used to determine differences in emergency room use and rate of hospitalization.      

Principal Findings. Compared to the control group, users of periodontal services during the first 2 years of diagnosis have significantly lower total healthcare costs over years 3 and 4 (‑$3167.20, p<0.05). However, there is not a statistically significant difference in hospitalization or emergency room visit rates.

Conclusions. There is evidence that periodontal treatment soon after initial diagnosis of diabetes can lead to lower overall healthcare costs in subsequent years.

Keywords. Periodontal disease, periodontal treatment, healthcare costs, hospitalizations, ER visits, diabetes.