How Regular Dental Visits Can Help Reduce Health Care Costs for People With Diabetes and Heart Disease

Regular preventative dental visits are associated with better health outcomes and minimized long-term medical expenses.

Woman at a dental check up
Photo: Getty Images

Fact checked on June 17, 2022 by Vivianna Shields, a journalist and fact-checker with experience in health and wellness publishing.

The benefits of getting your teeth cleaned go beyond dental care. Regular cleanings also appear to help prevent more significant and costly health challenges for those with diabetes and coronary artery disease, according to new research from the Mayo Clinic.

The study, published in Compendium of Continuing Education in Dentistry, researched how preventative oral care impacts the costs associated with care related to diabetes and coronary artery disease. The findings showed that regular dental cleanings and exams translate into significant savings in overall health care costs.

"Besides better oral outcome, regular preventive dental visits are associated with better health outcomes among patients with diabetes and chronic artery disease, resulting in significant savings in health care costs," lead investigator Bijan Borah, PhD, a health services researcher at Mayo Clinic told Health.

Interestingly, cost is one of the primary reasons people avoid going to the dentist, as many health insurance plans do not include dental coverage.

Here's a closer look at the ramifications of the study for your health and your finances.

Regular Dental Care Helps Lower Health Care Costs

Because previous research has associated periodontal disease—an infection in the gums, or the tissues that hold your teeth together—with other medical conditions like heart disease, diabetes and obesity, the Mayo Clinic research team set out to evaluate how regular, preventive dental care might impact overall health care costs.

The question is particularly relevant as ​​past research suggests that the bacteria behind gum disease can travel throughout the body, triggering systemic inflammation. In addition, poor oral health has been linked to numerous health conditions.Beyond diabetes and heart disease, a relationship has been established between poor oral health and pneumonia, Alzheimer's disease and even cancer.

The irony of this connection is that cost is quite often a barrier to dental care and most insurance plans, including Medicare, do not include dental care. As a result, many people avoid regular teeth cleanings and exams. But a healthier mouth has been linked to less hospitalizations, and consequently, reduced expenditures.

To examine the question of health care costs, Mayo researchers recruited 11,734 people who had either diabetes or coronary artery disease, or both conditions. Participants were enrolled in a health care plan in Arkansas that included dental care coverage. The participants were enrolled in the plan for at least a year between 2014 and 2018.

The team compared the total health care costs — specifically, claims for inpatient and outpatient care and prescription medication costs — of those who had gone to at least one preventive dental visit to those who did not receive any preventive dental care.

The study found that people with diabetes who received preventive dental care saved, on average, $549. Those with coronary artery disease who visited the dentist saved $548 and patients with both conditions who visited a dentist saved about $866.

"While the finding does not establish causality between preventive dental visits and health care costs, the significant savings in health care costs among diabetes or chronic artery disease patients who made regularly preventive dental visits compared to those who did not suggest better health outcomes, specifically in terms of reduced inpatient hospitalizations," Borah said.

Oral Care Impacts Overall Health

Cindy Zhou, MD, a periodontal surgeon with the Mayo Clinic, says that the mechanisms behind the link between periodontal disease and other health conditions is still being investigated, but research has consistently found that oral bacteria can spread beyond the mouth and contribute to other health issues.

The spread of this bacteria may lead to an increase in inflammation, endothelial cell dysfunction, gut imbalances, and immune suppression. "As chronic low-grade inflammation is noted in many metabolic disorders, patients with periodontitis may have altered metabolic-inflammatory conditions leading to an increase in the systemic inflammatory burden," Dr. Zhou said.

The same bacteria behind gum disease have been found in plaque associated with heart attacks and strokes, says Deepik Dhama, DDS, a dentist and owner of multiple dental clinics supported by Pacific Dental Services, told Health. Oral infections can also increase blood sugar levels and make it more difficult to manage diabetes; and uncontrolled diabetes can raise blood sugar in the mouth.

Oral health plays a role in many other health conditions as well. Oral bacteria and inflammation can contribute to pneumonia, rheumatoid arthritis, pancreatic and kidney cancer, Alzheimer's disease, stroke, endocarditis and even premature death, Karin Arsenault, DMD, MPH, an assistant professor in the Department of Public Health and Community Service at Tufts University School of Dental Medicine, told Health.

The risk of oral health issues increases with age as many medications reduce saliva flow, contributing to dry mouth and tooth decay, Arsenault added. Aging also comes with a higher risk of gum disease.

Research has found that treatment of periodontal disease can lower inflammation and improve other systemic health conditions. "Preventative dental care and screenings help preserve your teeth and remove harmful bacteria that may exacerbate current conditions and lead to bigger issues," said Dhama. Dental care is a critical part of whole-body health.

Costs Prevent People From Visiting the Dentist

Because it's an added expense, many people opt out of dental care coverage. Data from the Centers for Disease Control and Prevention (CDC)shows that 50% of adults ages 18 to 64 in the U.S. don't have dental care; 22% of those with dental care coverage didn't see a dentist within the past year.

Furthermore, when people retire, they lose dental insurance through their provider. Medicare does not include dental care coverage, meaning dental care becomes an out-of-pocket expense. Of those 65 and older, only 30% had dental insurance as of 2017. As a result, many people, especially older adults, skip out on routine care.

Arsenault says everyone should have access to routine dental care. Having private dental insurance opens access to care — but there are other ways to find affordable dental care. Many dental schools host clinics where dental students can treat patients at reduced prices. Federally-qualified health clinics also offer sliding fee scales where people pay what they can afford. Faith-based groups and charities often donate dental services, too.

The American Dental Association recommends that people visit a dentist and have their teeth cleaned and examined at least once a year, if not twice a year or quarterly depending on a person's underlying health.

Regular dental check-ups can help find health concerns and intervene early. Postponing care means that oral conditions can worsen, become more expensive, and start impacting nutrition, socialization, overall health and quality of life.

"For those with chronic systemic inflammatory diseases, such as diabetes and coronary artery disease," said Dhama, "keeping up with dental maintenance is essential to prevent further health complications."

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

Was this page helpful?