Periodontal Therapy Reduces Hospitalizations and Medical Care Costs in Diabetics

Objectives: The aim of this study was to determine if periodontal treatment was associated with the number of hospitalizations and cost of medical care among diabetics with periodontal disease.

Methods: A longitudinal study compared medical costs for diabetic subjects with periodontal disease (1) who received periodontal treatment versus (2) periodontally untreated controls over a three year period (2007-2009, N=1,696,062, including 91,524 type II diabetics). Subjects were enrolled in Highmark (Blue Cross) medical and UCCI dental plans, and received medical and dental services. The periodontal treatment group was treated in the first year, and maintained thereafter. The control group had received incomplete periodontal therapy prior to baseline, and did not receive regular maintenance during the study. A multi-variant analysis of the variance was used with the following variables sex, age and periodontal treatment. The primary outcome was the mean number of hospitalizations in 2009. Other outcomes were number of physician visits mean medical costs in 2009.

Results: The prevalence of periodontal disease and type II diabetes increased with age. The mean number of hospitalizations and physician visits were reduced by 33% and 13%, respectively, in the subjects who received periodontal care when compared to controls. Similarly, medical costs were significantly reduced by $1,814 per subject per year (25% reduction). The data for diabetic subjects categorized by periodontal treatment group are shown in the table below:

				periodontal treatment			control group
				group N=773			N=60,706		P
	mean hospital admissions/100 diabetics			5.9±0.2			9.0±0.2		<0.02
	mean medical visits			16.4±0.80			19±0.08		<0.0001
	mean medical costs			$5,522±926			$7,336±101		<0.05

Conclusions: Periodontal treatment was associated with a significant decrease in hospital admissions, physician visits and overall cost of medical care in diabetics. Savings averaged $1,814 per patient in a single year independent of age and sex. A 33% decrease in hospital admissions was observed.

Supported by UCCI.