Ensuring that patients with diabetes and pregnant women have access to dental care presents a significant opportunity to improve health and save medical costs. These populations are more likely than the general population to have oral health problems and the consequences can be severe.
Untreated Oral Disease Causes Expensive Health Problems
- Gum (periodontal) disease can make it more difficult for people with diabetes to control their blood sugar, which can lead to blindness, amputation, heart disease, and kidney disease.
- Gum disease may cause pregnancy complications, including pre-eclampsia (dangerous high blood pressure) and gestational diabetes.
Treating Oral Disease Can Generate Significant Savings
- Research has found that treating gum disease in patients with diabetes reduces hospitalizations by 40%, saving $2,840 per person annually, on average. 1
- For pregnant women, dental care can reduce medical costs by $2,433 per person, per year for pregnancy complications.1
- Women who get regular dental care during pregnancy can improve their baby’s oral health as well as their own. Treating mom’s decay before birth can protect the baby’s teeth from infectious cavity-causing bacteria.
- If captured for the Washington State Apple Health (Medicaid) population, expanding dental benefits can generate net savings of more than $18 million over the biennium.
Proposal: $10 million in state funds over the biennium
- Increase Apple Health benefit from 1 to 4 allowable gum disease treatments each year based on each at-risk patient’s clinical needs and evidence-based practice standards.
- Enhance Apple Health’s reimbursement rate for dental providers serving patients with diabetes and pregnant women.2, 3
Want to Help?
Do you have diabetes? Or, are you pregnant or a new mom? Have you had oral health problems or difficulty accessing dental care? If so, contact us and share your story. Your experiences can help improve access for others. There are many ways you can get involved: share your story in writing, on video, or in person.
1 Jeffcoat, M. et al. Impact of Periodontal Therapy on General Health. American Journal of Preventive Medicine, 47, 166–174, August 2014. Available at: http://www.ajpmonline.org/article/S0749-3797(14)00153-6/abstract.
2 Evidence from the Access to Baby and Child Dentistry (ABCD) program indicates that providers are more willing to see Apple Health patients when payment rates for select procedures are raised closer to usual and customary rates.
3 Washington’s Medicaid adult reimbursement rates are among the lowest in the country. See: Nasseh, K. et al. A Ten-Year, State-by-State, Analysis of Medicaid Fee-for-Service Reimbursement Rates for Dental Care Services. American Dental Association’s Health Policy Institute, October 2014. Available at: http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1014_3.ashx