Periodontal treatment needs in a Medicaid expansion population

Lack of routine dental care can lead to oral complications. Recent studies connected periodontal disease with other health concerns such as cardiovascular diseases and diabetes. With new evidence linking periodontal disease and serious health problems, it becomes concerning that approximately 50% of the U.S. population suffers from the disease.

The Dental Wellness Plan (DWP) is part of Iowa’s Medicaid expansion program providing dental coverage to low-income adults not categorically eligible for Medicaid. DWP patients must “earn” benefits by maintaining dental appointments. This earned benefits approach delays periodontal treatment as patients must earn this procedure, potentially worsening disease.

This study was a secondary data analysis of electronic health records (EHR) at the University of Iowa College of Dentistry. It assessed periodontal treatment needs by determining whether an individual required periodontal disease treatment or routine dental cleaning. It also explored the relationships that exist between treatment need, systemic health conditions, and socio-behavioral factors among DWP in comparison with other insurance types.

It was found that 54% were indicated for periodontal treatment. Predictors of SRP need were found to be: Age (p<.0001), gender (p<.0001), diagnosis of diabetes (p=.031), smoking status (p<.0001), and not receiving regular dental check-ups (p<.0001).

Interestingly, insurance status was not significantly associated with periodontal treatment needs. However, approximately 50% of patients with all insurance types were indicated for SRP. While a large portion of the study population were indicated for periodontal therapy, delaying of treatment in the DWP program could exasperate systemic health and worsen periodontal health of these individuals.