Each year, growing research continues to reinforce the connections between oral health and overall health. For people with chronic conditions such as diabetes, those connections are even more critical.

So, when a health system expressed interest in developing a program focused on improving the health of its members at risk for diabetes, DentaQuest jumped at the opportunity to help create a pilot program.

The result, the Chronic Conditions Outreach Program, was launched in June of 2020. This program pairs education and outreach in three specific ways:

• Providing oral health education to members diagnosed with diabetes or prediabetes
• Assisting with the utilization of oral health benefits and scheduling a dental visit
• Disseminating information to providers regarding the Chronic Conditions program

“Providing oral and system health education together can help improve overall quality of care,” says Kelly Schroeder, RDH, MS, senior national outreach specialist at DentaQuest.

The Hidden Risks of Periodontal Disease and Diabetes

The insidious nature of periodontal disease makes this outreach and education especially important. In the early stages, periodontal disease is asymptomatic, which means the signs often are not visible until there is permanent tissue damage.

“Although gingivitis — inflammation of the gums — is reversible through brushing and flossing, left untreated, bacteria will cause destruction of tissues below the gum line,” says Ivy Beville, RDH, BASDH, outreach supervisor at DentaQuest. “That’s when it becomes periodontal disease, eroding bone support and causing the loss of teeth over time — which is not reversible.”

While periodontal disease doesn’t cause diabetes or vice versa, the two can influence each other.

“If you have diabetes and unmanaged periodontal disease, it can make it more difficult to manage your blood sugar,” Beville explains. “High blood sugar levels and some diabetic medications can also affect your mouth. In fact, infections and dry mouth are among the most common signs of diabetes.”

The diabetes epidemic continues to affect millions of lives every year. A new CDC publication, the National Diabetes Statistics Report 2020, highlights several statistics:

• Just over 1 in 10 — 34.2 million — Americans have diabetes.
• Approximately 1 in 3 — 88 million — American adults have prediabetes.
• New diabetes cases were higher among non-Hispanic Black people and people of Hispanic origin than non-Hispanic Asian and non-Hispanic white people.

The Chronic Conditions Program focuses on education for members who have been diagnosed with diabetes or prediabetes and encourages members to seek routine preventive dental care. Members receive outreach through live or automated calls and often receive assistance with scheduling a dental visit. Members who receive a postcard are reminded they can prevent oral health problems by eating well, managing blood sugar and getting regular dental checkups.

“The goal is that after members receive outreach, they will be motivated to schedule a dental visit,” Schroeder says.

Medical-Dental Integration in Action

Beyond member outreach, the Chronic Conditions Program supplies dental and primary care providers with resources to encourage members to seek the care they need to manage their health. The program also helps facilitate collaboration between medical and dental offices to ensure that dental care is included as part of disease management. This approach aims to promote better health outcomes while reducing costs and providing efficient and effective care.

“We’ve seen that siloed care contributes to lack of collaboration between dental and health care providers,” Schroeder says. “Fortunately, the industry is starting to find ways to incorporate medical and dental care. For example, a dental provider cannot diagnose diabetes, but they can recognize periodontal symptoms that might be a red flag. They can ask questions about family history and suggest talking to a primary care physician about getting screened.”

Dental providers receive information regarding the Chronic Conditions Program so they are aware that DentaQuest is encouraging members with diabetes to seek routine preventive care.

“In order for this program to be successful, collaboration with dental providers is important,” Schroeder adds.

Similarly, primary care doctors can talk to patients who have diabetes or are pre-diabetic about the importance of maintaining oral health and visiting the dentist for regular preventive care.

While the Chronic Conditions program is only a year old, Beville and Schroeder already see signs of success and potential growth. They are collecting data and hope to expand the model to include other chronic conditions, such as heart disease and cancer, in the future. DentaQuest plans to roll out this program in four new markets this year.

“This is an example of medical-dental integration,” Schroder says. “This program is highly targeted for those with diabetes and proving to be effective with encouraging preventive oral health care.”