Periodontitis, an inflammatory disease affecting the gums, and type2 diabetes are both common diseases in adults that are related in both directions: periodontal disease can affect diabetes and vice versa. CHDS researchers used micro-simulation modeling to show that nonsurgical periodontal disease treatment could avert tooth loss and microvascular diseases associated with diabetes, resulting in health care cost savings in addition to improved quality-adjusted life expectancy.
The micro-simulation model was built using data from nationally representative surveys, randomized controlled trials, meta-analyses, and other published sources. The study authors validated the model against observed data from large cohort and modeling studies following best modeling practices. Periodontal treatment effectiveness parameters were informed by randomized controlled trials and meta-analyses, which have previously shown effectiveness against tooth loss and diseases mitigated by type 2 diabetes (micro-vascular diseases affecting the eyes, kidneys, and nerves, and macro-vascular diseases such as heart attack and stroke). The model-based cost-effectiveness analyses showed that expanding periodontal treatment among individuals with type 2 diabetes had expected net lifetime discounted savings of $5,904 per-person with an estimated gain of 0.6 quality-adjusted life years. The benefits would likely accumulate among demographic groups (low-income non-Hispanic blacks and Mexican Americans and older populations) that have remained the high risk groups for type 2 diabetes and periodontitis and would thus address social and economic determinants of health disparities.