Why dentists need to engage in discussions about periodontal disease

Dental insurer United Concordia recently issued a message about how research has linked oral care to overall health care savings, noting that when employees with certain chronic conditions get care for their periodontal disease their overall health care costs go down significantly.

Delta and Anthem are now jumping on this bandwagon, which means we are talking about 70 percent of dental insurers. And the government (Medicare, Medicaid and state entities) is paying very close attention.

The relationship between periodontal disease and systemic disease has been repeatedly stated, and periodontal care is recognized as fundamental and critical to chronic disease management. Yet most dentists aren’t engaged in this conversation in their practices. Most dental practices hold periodontal care as a secondary profit center-a way to raise hygiene production. The quality of periodontal care is most often left to the hygiene department with some minimal attention paid by the dentist. Given the culture of the dental practice, the focus of most dentists is directly on high-cost restorative care, where production is the central theme of the practice. Periodontal care and periodontal maintenance are not considered quintessential in a dental practice.

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The economic emphasis is clearly on controlling health care costs. The government, medical insurers and hospital compensation are shifting toward outcomes and cost reduction. Employers are demanding to control health care costs, too. Since some diseases that are expensive to treat and control can be directly and powerfully impacted by periodontal care, it is inevitable that the commitment to periodontal care will become paramount. Furthermore, seven out of 10 patients have some form of a dental plan, and nine out of 10 dentists take dental plans. Add on risk management tools such as PreViser, which was recently adopted by Northeast Delta, and it is inevitable that periodontal treatment will be directly enfolded into medical care.

In the next few years, the message about periodontal health will be stronger, more penetrating and required far more from outside the profession than from within. If periodontal health is not managed with patients who have chronic diseases, there will be economic consequences for the dentist. This will cause a shift in context so profound that dental practices will need to change. Dental practitioners can't see it coming, but it's about to hit them like the meteor that killed the dinosaurs.