title: Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions.
abstract: BACKGROUND
  Treatment of periodontal (gum) disease may lessen the adverse consequences of some chronic systemic conditions.
  
  
  OBJECTIVE
  To estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes (T2D); coronary artery disease (CAD); cerebral vascular disease (CVD); rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study.
  
  
  METHODS
  Insurance claims data from 338,891 individuals with both medical and dental insurance coverage were analyzed in 2011-2013. Inclusion criteria were (1) a diagnosis of at least one of the five specified systemic conditions and (2) evidence of periodontal disease. Subjects were categorized according to whether they had completed treatment for periodontal disease in the baseline year, 2005. Outcomes were (1) total allowed medical costs and (2) number of hospitalizations, per subscriber per year, in 2005-2009. Except in the case of pregnancy, outcomes were aggregated without regard to reported cause. Individuals who were treated and untreated for periodontal disease were compared independently for the two outcomes and five systemic conditions using ANCOVA; age, gender, and T2D status were covariates.
  
  
  RESULTS
  Statistically significant reductions in both outcomes (p<0.05) were found for T2D, CVD, CAD, and pregnancy, for which costs were lower by 40.2%, 40.9%, 10.7%, and 73.7%, respectively; results for hospital admissions were comparable. No treatment effect was observed in the RA cohorts.
  
  
  CONCLUSIONS
  These cost-based results provide new, independent, and potentially valuable evidence that simple, noninvasive periodontal therapy may improve health outcomes in pregnancy and other systemic conditions.
authors: School of Dental Medicine, University of Pennsylvania, Philadelphia. Electronic address: jeffcoat@dental.upenn.edu.
authors: Marjorie K
authors: MK
authors: Jeffcoat
authors: Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia.
authors: Robert L
authors: RL
authors: Jeffcoat
authors: Research Department, Highmark Incorporated, Harrisburg, Pennsylvania.
authors: Patricia A
authors: PA
authors: Gladowski
authors: United Concordia Companies Incorporated, Harrisburg, Pennsylvania.
authors: James B
authors: JB
authors: Bramson
authors: United Concordia Companies Incorporated, Harrisburg, Pennsylvania.
authors: Jerome J
authors: JJ
authors: Blum
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010510:Periodontal Diseases / Q000150:complications / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies