Periodontal therapy among patients with cardiovascular disease: exploring its association with lower medical spending

Cardiovascular disease (CVD) and periodontal disease are prevalent chronic conditions that share common risk factors and may be linked through systemic inflammation. Emerging evidence suggests that individuals with periodontal disease are more likely to be diagnosed with CVD, potentially influencing health care costs.

This study analyzed deidentified commercial insurance claims data from 192,500 United States (U. S.) adults aged 21-64 with CVD diagnoses between 2015 and 2022. Patients were categorized based on periodontal treatment received in 2020-2021: none, 1-3 visits, or 4 + visits. Gamma regression and multinomial propensity score matching (PSM) models assessed associations between periodontal treatment and 2022 health care costs (overall, outpatient, inpatient, and prescription), controlling for demographic and clinical covariates. Reported percentage reductions and average treatment effect on treated (ATET) dollar difference reflect estimates derived from PSM-weighted models.

Patients with four or more periodontal visits had significantly lower overall medical costs (9.6% reduction; ATET = -$1,960.39, 95% confidence interval (CI) = -$2,684.33, -$1,236.44, p < 0.005) and outpatient costs (5.3% reduction; ATET = -$599.09, 95% CI = -$1,019.34, -$178.84, p < 0.005) compared to those without treatment. Patients with 1-3 visits had an 8% reduction in prescription costs (ATET = -$387.53, 95% CI = -$653.31, -$119.75, p < 0.005). Gamma regression analyses confirmed these associations after adjusting for confounders.

Findings suggest that periodontal treatment may be associated with lower health care costs among individuals with CVD, potentially attributed to reduced systemic inflammation. The cost differences were most pronounced with four or more periodontal visits, supporting risk-based recall strategies. These results underscore the relevance of integrating oral health into chronic disease management and indicate that greater access to periodontal care may be associated with economic and health benefits.