Impact of Periodontal Therapy on General Health

Jeffcoat, Marjorie K.; Jeffcoat, Robert L.; Gladowski, Patricia; Bramson, James B.; Blum, Jerome J.

doi:10.1016/j.amepre.2014.04.001

Cited by 164 publications

(61 citation statements)

References 12 publications

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“…Periodontitis is a public health problem in developed countries, with direct and indirect medical consequences and costs that can justify public health policies (Bouchard, Boutouyrie, Mattout, & Bourgeois, 2006;Jeffcoat, Jeffcoat, Gladowski, Bramson, & Blum, 2014;Kassebaum et al, 2014). Thus, epidemiological surveillance of periodontal diseases, especially of severe periodontitis, is of particular importance.…”

Section: Discussionmentioning

confidence: 99%

Self‐report assessment of severe periodontitis: Periodontal screening score development

Carra

Guéguen

Thomas³

et al. 2018

J Clinic Periodontology

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Section: Discussionmentioning

confidence: 99%

Self‐report assessment of severe periodontitis: Periodontal screening score development

Carra

Guéguen

Thomas³

et al. 2018

J Clinic Periodontology

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“…The increased prevalence of cardiovascular disease,27,28 hypertension,25 and stroke in periodontal disease25,29 has been attributed to a common susceptibility hypothesis, that of direct bacterial invasion of blood vessels, and/or a systemic inflammatory response leading to increased circulating cytokines that damage vascular endothelium 30. Importantly, treating periodontitis in patients with common comorbidities has shown to be an effective way of reducing both financial costs and admissions for cardiovascular disease and diabetes mellitus,31 lending credence to this hypothesis. Thus, both periodontitis and COPD occur with a similar spectrum of comorbid disease.…”

Section: Periodontitismentioning

confidence: 99%

Is periodontitis a comorbidity of COPD or can associations be explained by shared risk factors/behaviors?

Hobbins¹,

Chapple

Sapey³

et al. 2017

COPD

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COPD is recognized as having a series of comorbidities potentially related to common inflammatory processes. Periodontitis is one of the most common human inflammatory diseases and has previously been associated with COPD in numerous observational studies. As periodontitis and COPD are both chronic, progressive conditions characterized by neutrophilic inflammation with subsequent proteolytic destruction of connective tissue, it has been proposed that they share common pathophysiological processes. The mechanisms proposed to link COPD and periodontitis include mechanical aspiration of oral contents into the respiratory tree, overspill of locally produced inflammatory mediators into the systemic circulation or oral or lung-derived bacteremia activating an acute-phase response and also reactive oxygen species (ROS) and cytokine release by systemic neutrophils at distant sites. Studies of systemic neutrophils in COPD and chronic periodontitis describe altered cellular functions that would predispose to inflammation and tissue destruction both in the lung and in the mouth, again potentially connecting these conditions. However, COPD and periodontitis also share risk factors such as age, chronic tobacco smoke exposure, and social deprivation that are not always considered in observational and interventional studies. Furthermore, studies reporting associations have often utilized differing definitions of both COPD and periodontitis. This article reviews the current available evidence supporting the hypothesis that COPD and inflammatory periodontal disease (periodontitis) could be pathologically associated, including a review of shared inflammatory mechanisms. It highlights the potential limitations of previous studies, in particular, the lack of uniformly applied case definitions for both COPD and periodontitis and poor recognition of shared risk factors. Understanding associations between these conditions may inform why patients with COPD suffer such a burden of comorbid illness and new therapeutic strategies for both the diseases. However, further research is needed to clarify factors that may be directly causal as opposed to confounding relationships.

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“…The MEPS collects detailed information about medical and dental visits, health insurance, expenditures, and payments as well as socio‐demographic characteristics of the US community‐based population. MEPS respondents are interviewed five times over a 2‐year period . Persons in our sample were restricted to those with positive‐valued population weights in both years they were in the MEPS, so we excluded persons in their first year in the survey in 2014 and in their last year in the survey in 2008.…”

Section: Methodsmentioning

confidence: 99%

“…With the exception of RA, those completing treatment for PD had statistically significant reductions in medical costs and hospitalizations over the 5-year period. 13 A recent study estimated cost savings of $63.5 billion to Medicare beneficiaries with heart disease, diabetes, or stroke by hypothetically offering coverage for periodontal care including an initial treatment and follow-up annual maintenance visits over the period 2016-2025. 14 A study using 2002 Medicare Current Beneficiary Survey data found higher cost nonpreventive dental use and expenditures for Medicare dental patients who did not receive preventive oral services compared to those who did receive preventive care.…”

Section: Previous Studiesmentioning

confidence: 99%

“…A retrospective cohort study compared the annual per person medical costs and hospitalizations between 2005 and 2009 for those with PD who did and did not complete periodontal treatment in 2005 for those with 4 specific comorbidities identified between 2011 and 2013: type 2 diabetes, coronary artery disease (CAD), cerebral vascular disease (CVD), and rheumatoid arthritis (RA). With the exception of RA, those completing treatment for PD had statistically significant reductions in medical costs and hospitalizations over the 5‐year period . A recent study estimated cost savings of $63.5 billion to Medicare beneficiaries with heart disease, diabetes, or stroke by hypothetically offering coverage for periodontal care including an initial treatment and follow‐up annual maintenance visits over the period 2016‐2025…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does covering routine dental care for the Medicare population produce cost savings in Medicare? A preliminary 2‐year analysis

Moeller

Manski

Chen

et al. 2019

J Public Health Dent

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Objectives We estimated the association between the use of preventive dental care and medical use and expense for older persons over a 2‐year period to determine if a Medicare dental benefit for routine care could result in potential cost savings in Medicare. Methods We relied on 2008‐2014 Medical Expenditure Panel Survey data to estimate separate logistic and lognormal ordinary least squares regressions to analyze the influence of year 1 preventive dental care on either year 1 or year 2 use and expenses for total health care, office‐based care, outpatient care, inpatient stays, emergency department visits, and prescription drugs. Results Our findings provide evidence over a 2‐year period that a Medicare dental benefit for routine care could produce an increase in office‐based visits and expense. We also found that older persons currently using routine dental care have healthier lifestyles and greater access to care and use of preventive medical care than current nonusers. Conclusion Our results affirm the need for a longer‐term study to provide any conclusive evidence as to the ultimate impact of a Medicare dental benefit on other health care use and expenses.

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Impact of Periodontal Therapy on General Health

Abstract: 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.

Cited by 164 publications

References 12 publications

Self‐report assessment of severe periodontitis: Periodontal screening score development

Self‐report assessment of severe periodontitis: Periodontal screening score development

Is periodontitis a comorbidity of COPD or can associations be explained by shared risk factors/behaviors?

Does covering routine dental care for the Medicare population produce cost savings in Medicare? A preliminary 2‐year analysis

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