Method: The data were obtained from health and periodontal examinations and health insurance claims made between April 2008 and February 2011 for 294 Japanese subjects aged 80 years. Participants were classified by quartiles of periodontal inflamed surface area (PISA), which quantifies the degree of inflammation based on clinical attachment level, recession of the gingiva, and bleeding on probing. Multivariate analysis of the differences in medical expenditures among PISA quartiles was conducted using general linear models. Multivariate models were adjusted for gender, smoking status, and number of teeth.
Result: Least square means (LSMs) of total medical expenditures per month in the first, second, third and fourth quartiles were 22,140 yen (standard error 4,752), 23,147 yen (4,976), 26,382 yen (4,778) and 37,585 yen (4,883), respectively. Compared to the reference group (smallest PISA), participants with the largest PISA had significantly higher medical expenditures (p = 0.031). In addition, the test for trend showed a tendency for increased medical expenditures across PISA quartiles (smallest to largest) (p= 0.029).
Conclusion: A significant association was found between the total medical expenditures and the extent of periodontal disease as assessed by PISA, suggesting that maintaining good oral health is associated with systemic health and, ultimately, with reducing medical costs for the elderly.
Acknowledgement: This work was supported by 8020 Promotion Foundation.