There may be a link between periodontal disease (PD), diabetes mellitus (DM), and annual healthcare expenditures (HCEs), with individuals having both conditions paying more. This study was recently published in the Journal of Periodontology.
Furthermore, these findings highlight the need for medical-dental collaboration and policies supporting periodontal treatment for patients with diabetes to help lower healthcare costs, the authors wrote.
"A clear relationship between the comorbidity status of PD and DM and annual HCEs was demonstrated, indicating that subjects with coexistent PD and DM had increased annual HCE," wrote the authors, led by Anna Kinugawa of the Tohoku University Graduate School of Dentistry in Japan (J Periodontol, January 18, 2025).
Using data from the Japanese Longevity Improvement and Fair Evidence Study, the cohort study analyzed healthcare claims and oral health screening statistics to assess the link between PD, DM, and HCE over one year. A total of 790 participants with an average age of approximately 63 were grouped into four categories, including PD-/DM-, PD+/DM-, PD-/DM+, and PD+/DM+.
PD and DM status were determined using PD screenings and medical claims data. Researchers used a generalized linear model and a two-part model to evaluate the relationship between comorbidities and differences in annual HCE, they wrote.
Of the participants, 458 (58%) had PD based on screening, and 66 (8.4%) developed new DM after the screening. The comorbidity groups included 43 (5.4%) in PD+/DM+, 23 (2.9%) in PD-/DM+, 415 (52.5%) in PD+/DM-, and 309 (39.1%) in PD-/DM-. Among the 66 participants with DM, only nine (13.6%) had severe DM, with seven (77.8%) in the PD+/DM- group.
The mean annual HCE for all participants was 84,100 Japanese yen ($538 U.S.) (standard deviation [SD] = 151,200 Japanese yen [$966 U.S.]), and 43 participants (5.4%) had annual HCEs of 0 Japanese yen. The coexistence of PD and DM (PD+/DM+) was associated with significantly higher annual HCEs, averaging 59,300 Japanese yen ($380 U.S.) (95% confidence interval [CI]: 14,171 Japanese yen ($91 U.S.) to 104,500 Japanese yen [$668 U.S.]), more than the PD-/DM- group while no significant differences were observed in other groups, they wrote.
The study had limitations, including potential selection bias. With low and highly variable screening rates across Japan, the results should be interpreted carefully and may not be fully generalizable, the authors added.
"These findings may suggest the importance of cooperation between medical and dental professionals in the treatment of DM and the need for policies that increase coverage for periodontal treatment in people with DM as a strategy to reduce HCEs," they concluded.
