Assessing the association between receipt of dental care, diabetes control measures and health care utilization.
BACKGROUND
The literature contains few studies regarding the relationships between receipt of regular dental care and medical outcomes for people with type 2 diabetes.


METHODS
The authors compared hemoglobin A(1c) (HbA(1c)) levels (< 7 percent versus < 7 percent), low-density lipoprotein cholesterol levels (< 100 milligrams/deciliter versus ≥ 100 mg/dL) and diabetes-specific hospital admissions and emergency department (ED) visits (one or more visits versus no visits) in 493 people with type 2 diabetes who received regular dental care (≥ two prophylactic visits, periodontal treatment visits or both during a 12-month period) with measures in 493 people with type 2 diabetes who did not receive any dental care. The authors matched patients, all of whom had private medical and dental insurance benefits during the study period, with regard to age, sex and previous utilization of ED visits and hospital admissions, and they followed them for three years.


RESULTS
The authors analyzed the data by using multiple logistic regression, which showed that receipt of regular dental care was associated with lower diabetes-specific ED utilization (odds ratio [OR] = 0.61, 95 percent confidence interval [CI] = 0.40-0.92) and hospital admissions (OR = 0.61, 95 percent CI, 0.39-0.95) after they adjusted for age, sex, previous hospital admissions, previous ED utilization, race, baseline HbA(1c) values, Charlson comorbidity index score, body mass index status, periodontal risk status and primary care utilization. The authors found no significant association between receipt of dental care and control of HbA(1c) levels.


CONCLUSIONS
The study results show an association between regular receipt of dental care and reduced diabetes-specific medical care utilization (that is, ED visits and hospital admissions).


CONCLUSIONS
Although the results of this study could not show causality, they suggest that receipt of dental care may reduce diabetes-specific health care utilization. Prospective studies are needed to better understand the relationship of receipt of dental care with diabetes control and health care utilization measures.
Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227-1110, USA. david.m.mosen@kpchr.org
David M
DM
Mosen
Daniel J
DJ
Pihlstrom
John J
JJ
Snyder
Elizabeth
E
Shuster
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003729:Dental Care / Q000706:statistics & numerical data*; D003777:Dental Prophylaxis / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010510:Periodontal Diseases / Q000628:therapy; D010512:Periodontal Index; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin