title: The effect of periodontal disease on medical and dental costs in a middle-aged Japanese population: a longitudinal worksite study.
abstract: BACKGROUND
  Although periodontal disease is one of the most common chronic diseases, it is not clear whether periodontal disease is associated with increased health care costs. The authors examined the effect of periodontal disease on medical and dental costs and use for 3.5 years prospectively.
  
  
  METHODS
  The data were derived from health and dental examinations and health insurance claims of 4,285 Japanese civil officers aged 40 to 59 years. The subjects were divided into three categories: no pathological pocket, moderate periodontitis, and severe periodontitis. Age, gender, smoking, body mass index, and hypertension were adjusted in a multivariate analysis after excluding subjects with any history of liver disease, heart disease, or diabetes mellitus.
  
  
  RESULTS
  The cumulative cost for subjects with severe periodontitis was approximately 21% higher than for subjects with no pathological pocket, and the hospital admission rates of subjects with severe periodontitis were highest (male: odds ratio [OR]=.34; 95% confidence interval [CI]: 1.00 to 1.80; female: OR=1.29; 95% CI: 0.75 to 2.20). In males, the annual hospital costs of subjects with severe periodontitis were 75% higher than for subjects with no pathological pocket. There was no clear trend identified for outpatient care. The annual dental visit rates and costs for subjects with severe periodontitis were highest in both genders. Periodontal disease might increase the medical care costs for diabetes mellitus, digestive disease, and liver disease.
  
  
  CONCLUSIONS
  Periodontal disease may have played an important role in the cumulative health care cost increases in middle-aged adults over a period of only a few years.
authors.affiliation: Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan. r-ochide@med.uoeh-u.ac.jp
authors.forename: Reiko
authors.initials: R
authors.lastname: Ide
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hoshuyama
authors.forename: Ken
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D044466:Asian People; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003729:Dental Care / Q000191:economics* / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000145:classification / Q000191:economics*; D012737:Sex Factors