Studies are needed to conclusively prove whether treating gum disease affects various conditions, says Bryan Michalowicz, an associate professor at the University of Minnesota School of Dentistry and lead author of the study.
"There are a number of criteria that have to be met before we can conclude that something is a cause," he says.
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Insurer incentives
The recent pregnancy study has given some experts pause, but so far it hasn't derailed a sweeping trend among insurers to offer improved dental care to certain high-risk members, such as pregnant women and people with diabetes and heart disease.
Several major insurance companies, including Aetna, Cigna and Delta Dental, have revised their plans in the last year or so to offer extra cleanings or additional dental services, such as paying for a prescription mouthwash, to high-risk individuals.
The insurers, particularly those who offer both medical and dental insurance, think they'll save money in the long run, says Evelyn Ireland, executive director of the National Assn. of Dental Plans in Dallas.
An analysis by Aetna and Columbia University College of Dental Medicine found that treating gum disease in high-risk individuals improved their health and lowered overall medical costs.
Under some plans, the member has to be referred by a physician to receive the extra cleaning or dental service. And increasingly, physicians are paying attention to their patients' oral health, says Miller. Just recently, he received two referrals from medical clinics. In one case, a patient was referred for treatment of gum disease before a transplant surgery. In another, a patient was referred for assessment of his oral health before he was cleared for valve replacement surgery.
"The leading medical centers are very aware of this and are actually requiring this before they do certain procedures," he says.
The relationship between oral health and overall health could -- and some would say should -- focus new light on the number of Americans who have no dental insurance and go years without any care whatsoever. Though about 44 million Americans lack medical insurance, at least 100 million are not covered by dental insurance, according to a 2000 Surgeon General report.
Says USC's Nowzari: "Even if we convince the public of the link between gum disease and other conditions, we have to face that challenge."
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shari.roan@latimes.com
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(BEGIN TEXT OF INFOBOX)
Gum disease
Gum disease is usually defined as having pockets of 4 millimeters or more around the teeth where the gums have pulled away and become infected.
Percentage of adults by age with at least one pocket of 2 mm, 4 mm or 6 mm
Ages 18-24
2 mm: 37.3%
4 mm: 3.0%
6 mm: 0.2%
25-34
2 mm: 60.5%
4 mm: 12.0%
6 mm: 2.6%
35-44
2 mm: 74.9%
4 mm: 22.1%
6 mm: 6.7%
45-54
2 mm: 86.4%
4 mm: 38.0%
6 mm: 13.9%
55-64
2 mm: 89.8%
4 mm: 50.2%
6 mm: 19.0%
65-74
2 mm: 94.5%
4 mm: 54.9%
6 mm: 23.4%
75 and up
2 mm: 95.7%
4 mm: 64.6%
6 mm: 29.5%
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Sources: National Center for Health Statistics, National Assn. of Dental Plans
