The Connections Between Periodontal Disease and Overall Health

It’s no secret that many people confront chronic illnesses, from heart disease to dementia, as they get older. We often hear about the importance of regular exercise and well-balanced diets to help us stave off these illnesses and stay healthy as we enter our seventh, eighth, and ninth decades.

Healthy gums can help, too.

The benefits of periodontal health go far beyond our mouths — especially as we age. Periodontal disease (PD) has a bidirectional relationship with several systems, diseases, and conditions throughout our body.

Policy and health care leaders can highlight those relationships — and promote periodontal health — this September during National Gum Care Month to improve adults’ overall health. They can work to expand access to insurance that covers preventive dental care, which, in the long run, will reduce Medicaid and Medicare spending and help reduce costs across the health care system.

First, let’s dive deeper into the connections, starting with the heart.

The Relationship Between Periodontal Disease and Heart Health

Periodontal disease can raise our risk of heart disease. More specifically:

• People who have PD are 28% more likely to suffer a heart attack than those with better gum health.
• Studies show that our periodontal health in childhood can impact our heart health later in life.
• Children who have cavities or other dental infections are more likely than others to face clogged arteries in adulthood — a dangerous symptom of cardiovascular disease.

The data speak to the importance of having access to preventive care early in life and throughout our lives.

Other Health Problems Associated with Periodontal Disease

PD is also tied to systemic conditions such as diabetes, dementia, and glaucoma.

When it comes to diabetes, being able to care for your gums is particularly critical. Data show:

• Diabetes can increase a person’s risk of PD by 86%.
• When people with diabetes have PD, it is more severe than for their peers without diabetes.

In a CareQuest Institute video, Mark Deutchman, MD, family medicine physician and professor at the University of Colorado, explains how PD and diabetes influence each other.

“Diabetics who have good oral health have it easier to control their blood sugar,” he says.

Meanwhile, poor oral health can make diabetes harder to manage. When someone with diabetes has poor gum health, Deutchman affirms that treating PD will “improve their diabetic care.”

Preventing PD and other dental disease is also crucial to our cognitive health.

Numerous studies point to the connection between dental health and dementia. Key findings highlight that:

• Losing teeth can raise a person’s risk of dementia, including Alzheimer’s disease.
• Tooth loss may even help providers predict that someone will develop dementia.

In addition to our neurological health, the state of our teeth and gums can impact our eyesight. Having PD can increase the likelihood of developing glaucoma.

Studies also find that eye disease can signal dental disease. Factors leading to poor vision can worsen our oral and overall health:

• Chronic conditions in other parts of the body, such as diabetes and heart disease, can cause visual impairment.
• These systemic diseases lead to poorer health overall and interfere with our dental health.

Preventing Periodontal Disease Can Save Money

Periodontal therapy is not a covered benefit in most state Medicaid programs. It’s a gap in benefits that unnecessarily increases health care spending.

In a review of Medicaid and private insurance claims of people with diabetes, CareQuest Institute researchers found that access to periodontal care led to greater savings for patients enrolled in Medicaid than those with commercial coverage:

• Diabetic patients enrolled in Medicaid who had PD treatment over two years saw 14% lower overall health care costs.
• Among privately insured people with diabetes, having PD treatment over two years reduced their health care costs by 12%.

Further CareQuest Institute analysis reveals cost savings for both inpatient and outpatient care among diabetics who obtained periodontal treatment, compared to those who did not receive such care.

Another example of how dental care generates cost savings comes from research on people in the hospital who are enrolled in Medicaid.

About 1 in 100 people get nonventilator hospital-acquired pneumonia (NVHAP) when they are admitted to the hospital, which can lead to sepsis and even death.

Recent studies report that getting preventive dental care before a hospitalization can reduce the risk of acquiring this infection. Among those covered by Medicaid who have been hospitalized:

• A patient is 30% less likely to get NVHAP if they had periodontal therapy in the six months before being admitted.
• People are 10% less likely to become infected if they had preventive dental treatment within a year before being hospitalized.

Preventing infections leads to cost savings:

• Treating NVHAP can cost $28,000–$40,000 per person.
• Providing periodontal therapy costs only about $500 per person.

Strengthening Periodontal Coverage under Medicaid Is a Cost-Effective Solution

From childhood throughout our adult lives, good periodontal health reduces the risk of myriad chronic conditions. Research on preventable infections, like NVHAP, adds to the evidence that a healthy mouth is vital to our overall health.

Yet limited periodontal benefits in programs like Medicaid and Medicare mean that people who have fewer resources often have a higher risk of illness. And that comes with greater health costs. While improved access to dental care is important to everyone, the health and economic gains stand to be greater for people with lower socioeconomic status.

Expanding dental coverage in public programs is a clear and important solution. More preventive care will lead to healthier gums, healthier communities, and lower costs for the health system.