Most people learn at an early age that regular brushing and flossing can help prevent cavities.
But what many don’t know is that good dental health is key to maintaining whole-person health – especially for people with certain medical conditions.
“During a routine exam, a dentist can often detect the first signs of underlying conditions such as diabetes, leukemia, or heart disease,” said Dr. Cary Sun, Cigna’s chief dental officer. “Regular treatment is crucial for these patients to help address needed dental treatment and prevent serious infections that can impact their overall health.”
Improving whole-person health has become a key focus in health care. Just as mental illness has shown to increase the risk of diabetes and heart disease, poor oral health can exacerbate those and other conditions, such as lupus and rheumatoid arthritis. In addition to improving overall health, obtaining routine preventive dental care can also reduce overall health care costs. A recent Cigna study found that on average, those who receive consistent preventive dental care can reduce their total medical costs by 4.4% per year. For those with diabetes, the savings was even higher – an average of 12.25% per year.
Improved Health Starts with the Mouth
The Cigna Dental Oral Health Integration Program was recently expanded to provide enhanced coverage for specific dental services to help individuals with 14 different health conditions.
The following medical conditions have known associations to oral health, so it’s important for patients with these conditions to see their dentists regularly to receive the dental treatment they need.
Diabetes that is not well-controlled can lead to periodontal disease – an infection of the gum and bone that hold the teeth in place, which can cause pain, bad breath, and tooth loss. Diabetes also increases the level of sugar in saliva, which can lead to thrush – a fungal infection that causes painful white patches in the mouth.
Heart Disease and Stroke
Studies have shown that people with poor oral health tend to have higher rates of heart disease and stroke. Some researchers believe the bacteria that causes periodontitis and gingivitis can travel through the bloodstream, causing inflammation and damage to blood vessels in the heart and brain. If fatty plaques block a blood vessel that leads to the heart, they can cause a heart attack. If they reach the brain and cut off blood supply, they can cause a stroke.
If a patient’s immune system is weakened by kidney disease, they could be more prone to infections caused by severe gum disease. Cavities and gum disease cause pain, difficulty eating, and mouth odor, and they can also fuel chronic inflammation, which can contribute to other medical conditions, such as heart disease. In addition, dental infections may delay a kidney transplant, making good oral hygiene essential.
Dental management is an important part of any organ transplant. Before the procedure, doctors want to ensure that patients are not suffering from infections or untreated dental issues that could further complicate the procedure. Afterward, anti-rejection medications may make it difficult for patients to fight bacteria and prevent infection.
Head and Neck Cancer Radiation
Dental treatment is also key for patients who receive radiation therapy for head and neck cancers. Radiation can cause mouth ulcers, damage a patient’s salivary glands, and cause dry mouth. Some patients experience a loss of taste, while others grapple with jaw stiffness and loss of tissue and bone in the jaw.
Sjogren’s syndrome is an autoimmune disorder that causes dry eyes and mouth. Many patients develop the condition as a complication of another autoimmune disease, such as rheumatoid arthritis or lupus. People with Sjogren’s Syndrome may have a hard time chewing certain foods, and brushing may be uncomfortable. The condition can also lead to thrush.
The connection between oral health and rheumatoid arthritis goes back centuries – Hippocrates suggested pulling teeth to cure arthritis. Researchers believe that bacteria responsible for inflammation in dental disease may prompt rheumatoid arthritis. In addition, pain and stiffness can cause jaw pain and make it harder for people with arthritis to brush and floss.
Patients with lupus are more likely to struggle with severe gum disease, as well as chronic ulcers and lesions on the lips, tongue, and mouth. The autoimmune disease also attacks glands that produce saliva, and some medications used to treat it can cause dry mouth.
Parkinson’s disease, a progressive disorder of the nervous system, can cause stiffness in jaw muscles, making it difficult to chew and swallow. This can increase the risk of choking and cause saliva to pool in the mouth, leading to infections. People with Parkinson’s are also more likely to have bacteria that’s associated with severe gum disease, which can infiltrate the bloodstream.
Amyotrophic Lateral Sclerosis (ALS)
ALS, also known as Lou Gehrig’s disease, weakens muscles and affects physical function, which can make brushing and flossing difficult. In addition, accumulation of saliva in the mouth can cause plaque and bacteria to build up, leading to cavities, gum disease, and pneumonia.
Huntington’s disease causes the progressive breakdown of nerve cells in the brain, affecting the functioning of the hands and arms. Patients with the disease have shown to have significantly more decayed teeth than those who do not. They can also grind and clench their teeth, leading to pain, tooth fractures, headaches, and TMJ disorders.
Opioid Misuse and Addiction
Adolescents and young adults have shown to be at greater risk of developing an opioid addiction. Dentists can be the primary source of first-time exposure, particularly following wisdom tooth extractions. At Cigna, we have worked with dentists to help reduce opioid prescriptions and we have also initiated limits on opioid prescriptions to a three-day supply for patients who undergo dental procedures.
Opioid misuse can cause dry mouth, which can lead to mouth sores, gum disease, and tooth decay. Combined with increased sugar consumption, dry mouth can be more destructive to the teeth. Opioids can also cause acid reflux, which can damage tooth enamel and gum tissues.
A pregnant woman’s changing hormones can cause inflammation in the gums. According to the Centers for Disease Control and Prevention (CDC), one in four women of childbearing age also have untreated cavities, and children of mothers who have high levels of untreated cavities are more than three times more likely to have cavities.
Preventive Care Is Key
In many cases, regular preventive dental care can help mitigate many of the oral side effects of these medical conditions, so it’s important for patients to brush and floss daily, keep their dentists informed of their health status, and schedule regular checkups.
Preventive Dental Care can Help Lower Medical Costs and Promote Positive Outcomes
The Cigna Dental Oral Health Integration Program reimburses out-of-pocket costs for specific dental services used to treat gum disease and tooth decay.