As the new year begins and people place a renewed focus on their health goals, employers would do well to renew their focus on dental care as a part of their employee wellness plans, given industry statistics on a correlation between dental care and overall health.
The well-established connection between dental health and overall wellness means employers could save money on health care costs and absenteeism by encouraging employees to have regular dental checkups.
Dental Associates, which has 14 clinics in Wisconsin, including Appleton, Green Bay, Fond du Lac and Greenville, several years ago started better exploring a patient’s general health using an evidence-based dentistry approach, says Dr. John Zweig, chief dental officer for Dental Associates.
“What we found was that many medical plans were looking to dentists to improving oral health to improve the welfare of their patients,” Zweig says.
As a result, Dental Associates recently added several new questions to its patient intake form that could connect oral health with medical issues. Among the health issues dentists ask about are:
• Gastroesophageal reflux disease, or GERD. Dentists can see evidence of the disease in lost enamel on the teeth.
• Sleep apnea. Bruxism, or grinding of the teeth, is connected to sleep apnea.
• Diabetes. Gum disease appears with higher prevalence and may impact glucose control.
• Other problems. Patients who have kidney disease, heart disease, were treated for cancer or are pregnant may require an extra cleaning annually.
Patients who have any of these health issues may be evaluated more carefully to ensure optimum oral health and therefore better medical health overall.
Likewise, dentists generally ask about tobacco use, a history of bleeding or swelling gums, and check for any abnormalities that might be linked to other health problems.
“There are a lot of links between oral disease and systemic diseases of the body,” says Dr. Bob Villwock of Bellevue Family Dentistry.
While diseases may not always manifest in the oral cavity, poor dental health can certainly be a contributing factor, Villwock says. That’s why a team approach with physicians can best assist the patient whenever dentists notice something out of the ordinary.
Early research also shows some link between cancers and the oral cavity, and dentists are often the first to spot oral cancers. Bacteria found in the heart muscles of heart attack patients has been shown to also be present in gum tissue.
“Whether it comes from the mouth all the time is probably up for debate,” Zweig says. “But because they’re finding it, and if your oral health is not optimum, then that might be contributing toward exacerbating the heart problems.”
Additionally, oral problems can grow worse when some patients contract a serious disease, as they may have trouble maintaining their dental health, Zweig says.
“If they can benefit from additional help from a dental hygienist or even a dentist for that matter, then we may be improving their ability to control their health condition and actually reduce costs,” Zweig says.
The evidence that dental care reduces medical costs is abundant: Dental Trade Alliance says the U.S. health care system could save $39 billion if 60 percent of diabetic adults received treatment for periodontal disease. A 2015 study published by the National Center for Biotechnology Information (NCBI) showed that African-Americans with severe periodontal disease developed chronic kidney disease at a rate four times greater than those without it.
Mayo Clinic also says health problems such as Alzheimer’s disease, osteoporosis, HIV/AIDS, endocarditis, rheumatoid arthritis and eating disorders can be evidenced, or exacerbated, by declining oral health.
Employers can help by encouraging use of dental benefits, or in the absence of dental benefits, by creating incentives to get regular checkups and cleanings.
“Some of the companies in the area do a points system for wellness,” Villwock says. “I’ve had to sign a lot of ‘report cards.’”
Dental insurance plans have not kept up with the times in terms of benefits, with annual maximums still about the same as they were in the 1980s, Villwock says. “If I were an employer, I would carefully look at whether I wanted to have dental insurance as a benefit or maybe do some form of direct reimbursement.”
Some medical plans have discovered that if patients maintain good oral health, they can reduce the costs those patients incur over time, Zweig says. “And it’s not small money — it’s tens of thousands of dollars, in some cases. So good oral health can contribute to improved medical conditions and thus reduce costs.”
Additionally, children who have poor oral conditions don’t do well in school and have a higher rate of absenteeism, Zweig says.
“It translates to the adult workforce, too,” he says. “People who have healthy mouths are able to function better, and to be the kind of worker and contributor that most employers would want to have.”