Contemplating Dental Benefits
How Dental Insurance
Can Reduce Medical Costs
by Robin Muck

Ten years ago, you would probably get a skeptical response if you said that adding group dental insurance could help a company save on medical claims. Attitudes began shifting slightly in 2000 when the Surgeon General published the first in-depth oral health study, which explained that you cannot have good overall health without good oral health. People in the medical and dental industries started talking about the relationship and researchers began to look more closely at a connection, which was first identified by Hippocrates more than 2,000 years ago.

We now know that more than 90% of all systemic diseases produce oral signs and symptoms, according to the Academy of General Dentistry. Today, dental care professionals are playing a key role in screening for conditions, such as heart disease, cancer, diabetes, leukemia, and osteoporosis.
Many forward-thinking companies and organizations across the country are taking this adage to heart: “Prevention is the best medicine.” American Heart Association CEO, M. Cass Wheeler, brought home the importance of preventive getting care in a 2005 news conference, “Not only does it save the individual the ordeal of getting sick, prevention programs could save the nation possibly billions, in direct and indirect medical costs associated with managing diseases after they present themselves.”

Wheeler estimated that heart disease, stroke, and other car-–diovascular diseases would cost the nation $493.5 billion in direct and indirect costs that year. How much of this cost could be eliminated if there was a way to detect heart disease in its earliest stages? There’s no doubt the savings would be considerable. In some instances, catching heart disease early could be as simple as seeing a dentist.

Some of the first indications of heart disease may be swollen or bleeding gums, mouth ulcers, and dry mouth, according to the Academy of General Dentistry. Having these symptoms doesn’t mean you have heart disease, but it is a sign that you should probably have further tests. By moving quickly to get a diagnosis and start a treatment program, it may be possible to avoid a debilitating heart attack or stroke and avoid the treatment costs.

Periodontal (gum) disease, which is the number one cause of tooth loss, can also be the sign of many other systemic conditions. The American Academy of Periodontology and American Dental Association support recent research indicating women with periodontal disease are seven times more likely to have pre-term and low-birth-rate babies. The March of Dimes estimates a pre-term delivery can cost 15 times more than a full-term delivery and result in thousands of dollars in additional costs. In 2002, the Healthcare Cost and Utilization Project estimated that employers and other private insurers were billed $7.4 billion in hospital charges for premature infants. A comprehensive dental exam early in pregnancy will detect periodontal disease. Treatment within the second trimester has been shown to lower the risk of a pre-term delivery.
So how does dental insurance factor into this equation of more dental care equals lower medical claims costs? Nearly all dental plans promote preventive and diagnostic care. Whether it’s a dental HMO or PPO, preventive care is generally provided to the enrollee at no cost or almost no cost in order to encourage regular oral exams, X-rays, and cleanings. The assumption is that since preventive care is perceived as basically free, enrollees are more motivated to establish a regular oral health care routine including twice-yearly visits to the dentist.

Picking the Perfect Preventive Plan
Choose a plan that emphasizes preventive care and diagnostic procedures. Cancer screenings should be covered and teeth cleaning should not be limited to only two a year. Comprehensive periodontal evaluation and periodontal maintenance are important parts of a well-balanced dental plan. They should be covered at reasonable out-of-pocket costs. A dental HMO plan is generally the best option to ensure that the employee has low treatment costs. Lower costs increase their motivation to use the benefits. It is also necessary to have strong network of dental care professionals to provide expanded choice for enrollees.

Promoting the Plan
The potential for actual savings is there for a well-designed plan that is promoted properly to employees. Open enrollment presentations shouldn’t be limited to explaining how the plan works. Information about the importance of good oral health should be a prominent part of any presentation. It is a good idea to provide educational brochures covering the most important points. Your dental benefit company should be able to give you a variety of brochures to use during open enrollment or health fairs. They should also be able to create customized communication pieces for the group’s plan to make sure that potential enrollees have the information they need to make educated decisions about their benefits.
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Robin Muck is the president of SafeGuard Health Plans Inc. of California. She has more than 20 years of experience in healthcare with organizations, such as Novaeon, a national health and disability management company where she served as VP, Sales, and Account Management. At CCN, a national managed care company, she held various positions including VP of National Accounts and VP of National Sales. Robin is on the board of California Association of Dental Plans and the National Association of Health Underwriters. You can contact Robin at 949-425-4371 or robinm@safeguard.net.