Dental Disease and Overall Health

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Gum (Periodontal) Disease, Overall Health, and Tooth Decay: Definition

All tooth decay and gum disease are of bacterial origin. What is commonly referred to as dental disease is actually two separate diseases: tooth decay and gum disease. You can have one without the other or both simultaneously. The terms “gum disease” and “periodontal disease” are often used interchangeably, even though periodontal disease is much more destructive. Clinically speaking, gum and periodontal disease can be broken down into two categories: gingivitis, the initial and milder form of gum disease, and periodontitis, the more advanced and serious form that infects the bone surrounding your teeth. I will use these terms interchangeably. 

The effect that gum disease has on overall health is directly related to the extent and duration of the infection. Moderate to advanced gum disease exposes the body to excessive amounts of harmful bacteria 24 hours a day, seven days a week, for as long as the infection is present. The stress this bacterial infection can place on the immune system is significant and it can dramatically reduce the body’s ability to fight other infections and diseases. 

Causes of Gum Disease and Tooth Decay

While the basic cause of tooth decay and gum disease is poor oral hygiene (due mainly to a lack of patient education and/or motivation) other factors are involved. Diet, smoking, vitamin deficiency, genetics, and exposure to toxic substances, such as mercury from amalgam fillings, can also contribute to dental disease. The more advanced form of gum disease is far more harmful to overall health. 

Certainly, tooth decay can affect one’s health and damaged or missing teeth can prevent proper chewing and thereby affect digestion. But while tooth decay can contribute to general health problems, its effects are considerably less than the effects of gum disease. 

Gum Disease: An Epidemic

Dental disease is an epidemic. Ninety percent of the population suffers from some form of this disease. Between 30 and 50 percent of the population has periodontal disease, the most destructive form of dental disease. 

Untreated, dental disease can lead to:

Gum Disease Dental Abscesses Tooth Decay
Tooth Loss Bad Breath Unsightly Teeth
Root Canals Allergies Pain & Discomfort

Anyone who has experienced any of the above dental problems can attest to the fact that they are no fun to deal with. But dental disease also generates a great deal of stress and over 50% of the population suffer some degree of fear and anxiety because of it. In addition, dental treatment can be very time consuming and expensive, especially when added up over a lifetime. 

Gum Disease and Your Overall Health

Of course all that is bad enough but the damaging effects of dental disease are not limited to the teeth and gums. It can and does negatively impact the overall health of the body. Yet, as destructive as dental disease can be, most people, including many dentists and physicians, still believe that the damage it does is limited to the oral cavity. But the fact is that numerous scientific studies no longer support that long-held assumption. We now know that gum disease can contribute to and increase the risk and severity of 

  • heart attack;
  • stroke;
  • diabetes;
  • low preterm birth weights;
  • respiratory disease;
  • osteoporosis; and
  • digestive disorders.

It can also severely stress the immune system and lower the body’s resistance to infections. As you will read as you make your way through my Website, if you don’t address your existing oral health issues, especially gum disease, your overall health will continue to suffer. 

Health Care Costs Related to Gum (Periodontal) Disease

The following studies provide evidence of the dramatic effect of periodontal (gum) disease on health care costs. in 2007, in the US alone, we spent

$2.2 TRILLION on health care. One study demonstrated that 21% of total health care costs could be saved by eliminating periodontal (gum) disease. That is nearly $500 billion dollars a year in savings simply by eliminating gum disease.

We already know that preventing gum disease and tooth decay can save at least 60% of all dental care costs, which amounted to nearly $100 billion in 2007. Thus $60 billion a year in dental care costs could be saved by preventing gum disease.

These are significant savings yet the government and the business community seem unwilling to look at this or insist that dental patient education must be a part of any health care reform and insurance coverage. The focus in the US regarding health and dental care has always been on treatment, with little emphasis on education and prevention. Yet no amount of treatment, no matter how well it is done, has ever prevented anything.

And the cost to the government and the business community doesn't stop with the cost of treatment. Employed adults lose more than 164 million hours of work each year due to oral health problems or dental visits. That is an added burden on the economy and one that can be easily prevented. If you are concerned, and you should be, contact your congressional representative.

If you are an executive of a company who self-funds your dental plan, or a health care administrator, or benefits executive, you will want to know how you can dramatically and cost-effectively reduce these costs. For more information please contact me at 800-335-7755.

The Studies

The Effect of Periodontal Disease on Health Care Costs," by R. Ide, T. Hoshuyama, and K. Takahashi

Prevention of periodontal disease may lead to saving of not only dental care but also medical care costs. Health care costs are useful units of measurement with which one can assess the economic impact of periodontal disease. Today, investigators presenting at the 84th General Session of the International Association for Dental Research reported the results of a study to evaluate the effects of periodontal disease on the use and costs of medical and dental care.

Using data from worksite health and dental examinations and health insurance claims of 4,285 civil officers aged 40-59 years, the researchers evaluated the effect of periodontal disease on medical and dental costs and utilization prospectively. Those with severe periodontitis accrued 21 percent higher total costs than those with no pathological pocket (periodontal pocket probing depth less than 4 mm) over the 3.5-year period. The admission rates of those with severe periodontitis were high for both sexes. In males, the dental costs for this group were approximately two-fold higher than those with no pathological pockets.

The investigators concluded that periodontal disease has a significant impact on health care cost increases, through not only dental care costs but also inpatient care costs, especially in males.

This is a summary of abstract #1779, "The Effect of Periodontal Disease on Health Care Costs," by R. Ide, T. Hoshuyama, and K. Takahashi, of the Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan, presented at the Brisbane Convention & Exhibition Centre, during the 84th General Session of the International Association for Dental Research.

Aetna And Columbia Announce Results From Study Showing Relationship Between Periodontal Treatment And A Reduction In The Overall Cost Of Care For Three Chronic Conditions. HARTFORD, Conn., March 20, 2006

Aetna (NYSE: AET) and Columbia University College of Dental Medicine conducted a study that found a relationship between periodontal (gum) treatment and the overall cost of care for several chronic diseases. The results of the study, which included approximately 145,000 Aetna members with continuous dental and medical coverage, indicate that periodontal care appears to have a positive effect on the cost of medical care, with earlier treatment resulting in lower medical costs for members with diabetes, coronary artery disease (CAD), and cerebrovascular disease (CVD) or stroke.

"The results of this study are encouraging because they show the connection between good oral health and overall well-being, as well as illustrating that the early treatment of periodontal disease can help reduce medical costs for these conditions," said Pat Farrell, head of Aetna Specialty Products. "We believe that in addition to lowering medical costs, we are also helping to improve members’ quality of life. We will continue to work with Columbia to demonstrate ways that dental care can improve the overall health of our members."

"Systemic health is often associated with the condition of the oral cavity in that many systemic diseases manifest in the mouth; however, less is known about the connection between a diseased periodontium and the impact it may have on systemic health," said David A. Albert, D.D.S., M.P.H., Associate Professor of Dentistry at Columbia University. "The association between periodontal infection and systemic health has important implications for the treatment and management of patients."

The retrospective study of claims data included an examination of approximately 145,000 members participating in Aetna PPO plans with continuous dental and medical coverage over two years. Periodontal care appeared to have a positive effect on the cost of medical care in this two-year study (2001, 2002), with earlier treatment resulting in lower medical costs for diabetes, CVD and CAD. In addition, the actual cost of medical care for patients with diabetes and CAD was found to be lower if they received periodontal care in the first year of the study.

“An examination of periodontal treatment and per member per month (PMPM) medical costs in an insured population”, David A Albert, et al.
The electronic version of this article is the complete one and can be found online at:

Overall Health Must Include Oral Health!