High-risk medical patients to benefit from new Delta Dental coverage
Wednesday, October 25, 2006
Expanded coverage to prevent oral disease and improve overall health
NASHVILLE, Tenn. – Delta Dental of Tennessee (Delta Dental), one of Tennessee’s largest dental benefits providers, announced today a new, innovative benefits package as part of its standard dental plan designs for new groups effective January 1, 2007, or upon renewal for current groups. The announcement comes as mounting scientific evidence suggests that early treatment and prevention of oral disease can improve quality of life and prevent premature death.
Delta Dental will enhance coverage for diabetics and pregnant women diagnosed with gum disease. It will also break new ground by offering special benefits for individuals with other high-risk medical conditions, including those experiencing kidney failure or who are undergoing dialysis, and those with suppressed immune systems due to chemotherapy and/or radiation treatment, HIV infection, organ transplant, and/or stem cell (bone marrow) transplant.
“By adding these additional cleanings and periodontal maintenance procedures, we hope to improve the overall health of our members and lower their total healthcare costs through advanced dental plan designs,” said Dr. Phil Wenk, DDS, president and CEO, Delta Dental of Tennessee.
It is well established scientifically that individuals with serious health conditions like these are at increased risk for infection. These individuals may benefit from having their teeth cleaned professionally at more frequent intervals to reduce the build-up of bacteria in the mouth. This can help lower the risk that bacteria will enter the bloodstream, create infection, and further compromise overall health.
The new benefits increase the frequency of dental or periodontal cleanings to four annually instead of the traditional two in an effort to keep gum disease in check. Some individuals with conditions or treatments that can increase tooth decay will also have access to beneficial fluoride treatment.
In addition to the enhancements for at-risk patients, Delta Dental will begin covering dental implants as part of its standard benefits, also effective January 1, 2007 (or upon renewal for current groups). That means enrollees will have the option of choosing an implant to replace a missing tooth instead of a conventional fixed bridge.
“Although implants have been available for many years, advances in dentistry have greatly increased their rate of success,” added Dr. Wenk. “Today, they are often the best method for replacing a single missing tooth in a healthy patient because there is no destruction to other healthy teeth as you might have with a bridge.”
Delta Dental was one of the first carriers to offer contract riders to employers wishing to cover this service and has closely monitored advances in implant materials, training, and technology. Dental implants are a means of replacing natural teeth, and are often a better alternative than a bridge. A conventional fixed bridge requires dentists to cut down and crown the teeth on either side of the missing tooth to support the bridge, whereas an implant doesn’t affect bordering teeth. In addition, implants generally have a lower cost over their lifetime than other tooth-replacement options.
Delta Dental will cover endosteal implants, the most commonly used type of implant, which is placed into the jawbone. Endosteal implants now have a success rate of 98 percent over 10 years. The other type of implant in use today, subperiosteal, fits on top of the bone under the gums. These will not be covered because they do not meet the level of success achieved with the endosteal implants.
“We commend Delta Dental for offering this expanded coverage to its members,” said Russ Gilpatrick, DDS, Dean of the University of Tennessee College of Dentistry at the UT Health Science Center. “The new evidence-based plan designs will encourage these at-risk patients to see their dentists more frequently, and hopefully help them avoid future oral health complications as well as other medical problems.” Helping Diabetics Control Blood Glucose Levels
A number of research studies, including one underway with Delta Dental support at the University of Michigan and University of Detroit Mercy, show that when diabetics have their teeth cleaned professionally, their blood glucose levels are easier to control. This is significant because glycemic control has proven to be one of the best ways to prevent complications of diabetes, which can include blindness, kidney failure, heart disease, stroke, nervous system disease, amputations, and pregnancy complications. It appears that for every one-point reduction in hemoglobin A1c, a blood test that is a standard measure of glucose control, there is a 40 percent reduction in the risk for diabetic complications. A one-point reduction also appears to decrease the incidence of heart attacks in diabetics by 14 percent and diabetes-related deaths by 21 percent. Helping Pregnant Women Give Birth to Healthy Babies
The increased frequency of cleanings will help expectant mothers give birth to full-term, healthy babies by preventing or minimizing gum disease, a condition that can increase the likelihood of premature birth. Scientific evidence has long indicated that pregnant women with gum disease are seven times more likely to give birth to premature babies. According to the National Institutes of Health, as many as 19 percent of the 250,000 premature low-weight infants born in the U.S. each year may be attributed to infectious oral disease. Improving the Oral Health of Patients with Other At-Risk Conditions
Individuals with other serious medical conditions will be eligible for the additional dental or periodontal maintenance cleanings when recommended by their dentist and physician. In addition to four cleanings annually, individuals who are undergoing head and neck radiation will also be eligible for coverage of professionally applied fluoride treatments twice each year. Because a common side effect of head and neck radiation is an increase in cavities, the National Institute of Dental and Craniofacial Research recommends fluoride treatment for those patients.
The new benefits will be included on all new business and upon renewal dates for all risk clients effective January 1, 2007. Delta Dental’s administrative services contract (ASC) clients will have the option to include the additional benefits in their custom plans upon renewal.
Delta Dental was a pioneer in using evidence-based research to evolve dental plan designs. It was the first dental benefits provider to change coverage for dental X-rays in the mid-1980s based on research that recommended reducing the frequency of X-rays for those not at high risk for tooth decay; as a result many patients have been protected from unnecessary radiation exposure. In 2004, it was one of the first to cover the cost of the brush biopsy diagnostic test for the early detection of oral cancer, a move that has saved lives and reduced health care costs.
Delta Dental of Tennessee is located in Nashville, Tennessee, and is a member of the Delta Dental Plans Association (DDPA) headquartered in Chicago, the oldest and largest dental benefits provider in the United States, with 39 individual plans in the U.S., Puerto Rico, the Virgin Islands and Guam. Delta Dental of Tennessee currently serves more than 750,000 members.
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