The impact of dental scaling and subgingival curettage on outcomes and healthcare utilization among patients with diabetes

• Main Authors: Ya-An Tsai, 蔡雅安
• Other Authors: Yu-Chi Tung
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/nwtuhn

碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 107 === Background: Hemoglobin A1c(HbA1c) is associated with severe periodontal ailment among patients with type 2 diabetes, and can be lowered by non-surgical periodontal treatment. However, data from empirical studies on diabetes and periodontal treatment interventions are not robust, as Taiwan lacks population-based data. Objective: To evaluate the effect of dental scaling and subgingival curettage on outcomes and healthcare utilization among patients with diabetes. Methods: The retrospective cohort study was designed using the database of National Health Insurance for secondary analysis. Patients diagnosed with type 2 diabetes and periodontal disease in 2017 were selected, and we have used propensity score matching to reduce bias between treatment and control groups on a large number of covariates. If the difference between the results of 2017 and 2018 diabetes outcomes and utilization is due to periodontal treatment intervention is to be ascertained. Results: After dental scaling or subgingival curettage, compared with those who did not receive the treatment, the ratio of odds of subsequent HbA1c below 7% was 1.065, and the risk of renal ailment was lower by 13%, and of hospitalization by 27%. The data analysis shows that there was an increase in the number of medical outpatient visits, of dental visits, and total dental expenses, but there was decrease in the average length of hospital stays, total hospitalization expenses, and overall medical expenses. Conclusions: Patients with type 2 diabetes and periodontal disease who have received periodontal treatment have better subsequent diabetes outcomes, and lower hospitalization need and overall medical care. Hence, we recommend that health policymakers consider the inclusion of dentists in Diabetes Shared Care team and institute relevant referral systems.