Appropriate Periodontal Therapy Associated with Lower Medical Utilization and Costs

Objectives: To test and quantify the association between periodontal treatment and medical utilization among patients with periodontal disease. Methods: This study was a retrospective case-control study that matched patients with periodontal disease over a three-year period (n=5,317 each for the Study and Control groups, from a total population of 3million). The Study group contained patients who received periodontal treatment in the first year (2009) and maintained regular continuous periodontal treatment in each subsequent year (2010 and 2011), whereas the Control group received periodontal treatment in the first year (2009) and didn’t receive regular periodontal treatment in each subsequent year (2010 and 2011). The matching required the following equivalence between the groups: age, gender, medical spend in first year. The primary outcome metric was the average admit-rate/1k. Secondary outcome metrics included the average emergency-room visit rate/1k, and the average total annual medical costs in the final year. Results: The admit-rate/1k patients was 67% lower in the Study group compared to the Control group (74.6 admits/1k vs. 223.3 admits/1k). The emergency-room visit rate/1k was also lower in the Study group by 54% (84.3 ER visits/1k vs. 184.6 ER visits/1k). The medical costs in the final year of the study period for the Study group were 28% lower when compared to that of the Control group ($2,688 per patient per year vs. $3,708 per patient per year). Summary of Results N Admit-Rate/1k ER-Rate/1k Average Medical Spend (Final Year) Study 5,317 74.6±11.4 84.3±5.9 $2,688±161 Control 5,317 223.3±23.2 184.6±9.2 $3,708±141 p-value <0.001 <0.001 <0.001 Conclusions: Appropriate periodontal treatment for patients with periodontal disease showed an association with lower hospital admissions, emergency-room visits, and medical costs. On average, appropriate periodontal treatment was associated with 149 fewer hospital admissions/1k per year, 100 fewer emergency-room visits/1k patients per year, and $1,020 lower medical costs per patient per year.