June 20, 2017

Column: Making the connection between dental, overall health

Courtesy of Tufts Health Plan
Dr. Claire Levesque is chief medical officer for commercial products at Tufts Health Plan of Watertown.

Sitting in the dentist's chair, few patients realize that their mouth is a gateway to the health of their entire body.

Without good oral health care, bacteria can build up on teeth, causing inflammation and gum disease, which can cause problems throughout the body. For example, gum inflammation seems to weaken the body's ability to control blood sugar for people with diabetes.

The good news is that treating one condition can help bring the other under control. Studies indicate that patients who have gum disease along with diabetes or other chronic conditions achieve better overall health outcomes when their gum disease is managed. Research also indicates that medical costs may be lower for these patients when they get care for their gum disease.

The opportunity for improved health outcomes and reduction in cost cannot be overlooked. As reported in the Journal of the American Dental Association, patients with diabetes have a three to four times higher risk of also having gum disease. A variety of other conditions are also linked to gum disease, including cardiac disease; stroke; pulmonary disease; rheumatoid arthritis; osteoporosis, and adverse pregnancy outcomes.

Collaborating for better health outcomes

Recognizing the link between oral health and overall health, Tufts Health Plan and Delta Dental of Massachusetts have formed an innovative collaboration. Working together as medical and dental insurance carriers, the goal is to improve the health of our members while controlling the rising costs of care.

We have identified opportunities for sharing medical and dental data to achieve better health outcomes, and for getting members and healthcare providers more engaged on the issue.

The collaboration builds off a pilot program that targeted people with chronic conditions who had coverage with both companies. It also follows a similar collaboration established last fall between Tufts Health Freedom Plan in New Hampshire, which offers employer–sponsored plans, and Northeast Delta Dental.

The central touchpoint for members with chronic conditions is the nurse care manager at Tufts Health Plan. This spring, our nurses received intensive training on the importance of good oral care in protecting overall health. The goal is to enhance the value of care through thoughtful, informed outreach to members and health care providers.

Employer discounts, innovation

Because we are confident in the potential for cost-savings from our collaboration, we are offering employers an insurance premium discount of up to 1 percent when they select coverage with both companies. The discount is available to employers with 250 or fewer enrolled employees (excluding small-group employers).

The key to closing the gap between oral and overall health is innovation, especially for members with chronic conditions like diabetes. For example, we are seeking permission from employer-group customers to analyze employee data, identify those with diabetes, and reach out with regular reminders to visit the dentist. Also, we are exploring the possibility of testing a patient's hemoglobin A1c levels right in the dentist's office to encourage better management of diabetes.

We realize that better overall health outcomes and lower costs will not be achieved immediately. But Tufts

Health Plan and Delta Dental of Massachusetts are committed to working together toward lasting improvements.

Dr. Claire Levesque is chief medical officer for commercial products at Tufts Health Plan, which has offices in Worcester.


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