Impact of leaving periodontal disease untreated on healthcare expenditures: A retrospective cohort study.

BACKGROUND

This study aimed to investigate whether healthcare expenditures (HCEs) differed depending on whether the patients left periodontal disease (PD) untreated, despite the need for treatment.

METHODS

This study used public PD screening data from a municipality in Japan to identify adults aged ≥ 40 years who were found to require treatment of PD by dentists at PD screening. The presence or absence of periodontal treatment was determined by a dental visit within 180 days after the date of PD screening based on medical claims data. Annual HCE were calculated from cumulative expenditures over 2 years from the date of the presence or absence of periodontal treatment. A generalized linear model with a gamma distribution and log link function was used to calculate the relative cost ratios (RCRs) and 95% confidence intervals (95% CI), and a two-part model was used to predict annual HCEs and the difference in predicted HCEs based on dental treatment.

RESULTS

Among 652 people (mean age: 62.6 years [1 SD = 9.0], 65.5% women), 9.0% were untreated. After adjusting for the covariates, the RCR for medical, pharmaceutical, and dental costs in the untreated group compared with the treated group were 1.56 (95% CI: 1.02-2.38), 0.95 (95% CI: 0.53-1.70), and 0.14 (95% CI: 0.10-0.19), respectively. The differences in predicted HCEs were $593.5 (95% CI: -280.6, 1467.6) higher for medical, $79.9 (95% CI: -363.6, 523.4) higher for pharmaceutical, and $323.9 (95% CI: -397.3, -250.6) lower for dental.

CONCLUSION

Leaving PD untreated was associated with increased HCEs, particularly medical expenditures.

PLAIN LANGUAGE SUMMARY: This study looked at whether people who were told by a dentist that they needed care for periodontal disease actually received treatment, and how this affected their healthcare costs. The research followed more than 600 adults in Japan for 2 years, comparing the cumulative healthcare costs of those who received dental care with those who did not. The results showed that people who did not treat their periodontal disease ended up spending more on medical care, even though they spent less on dental care. On average, untreated individuals had medical expenses that were around $600 higher than those who received treatment. This suggests that avoiding dental care for periodontal disease might lead to more serious health problems down the line, which can increase overall healthcare costs. Although skipping dental visits may seem like a way to save money, it could actually lead to higher medical bills in the future. These findings highlight the importance of early dental treatment not just for oral health, but also for managing overall healthcare costs and preventing other health complications.