Dental, health and disability insurers may be facing a hidden recession-related challenge: Persuading women to see the dentist.
When researchers at the Commonwealth Fund, New York, analyzed data from the health policy think tank’s 2007 health insurance survey, they found that 27% of the participating women who had health insurance had failed to get dental care in the past year due to concerns about cost, compared with just 22% of the insured male participants.
The gap was even more dramatic for participants without health coverage: 60% of the uninsured women had gone without dental care, compared with just 39% of the uninsured men.
The Commonwealth Fund published those figures in May, using the latest available data. Experts fear that access to dental care may have deteriorated since then, along with the state of the economy.
If that’s the case, women may be facing even greater pressure to avoid dental care at a time when some studies suggest that dental problems, and especially gum disease, may be associated with the likelihood that women will suffer serious, potentially disabling general health problems, such as pregnancy complications.
Proving that oral health problems are directly related to general health problems, rather than resulting from common causes, such as poverty or tobacco use, is difficult.
Preeclampsia, for example, is a relatively common pregnancy complication that can lead to premature birth, sky-high medical claims, and short-term or long-term maternal disability. Researchers at the University of the Valle de Cali, Colombia, reported in the Journal of Periodontology in February 2006 that 64% of the pregnant women they examined who had preeclampsia had chronic gum disease, compared with 36% of the women without preeclampsia.
Later in 2006, Tulane University researchers noted in BJOG, an international journal of obstetrics and gynecology, that some studies appeared to show no correlation between gum disease and pregnancy complications, but that clinical trials had indicated that providing extra gum care for pregnant women might lead to a 50% reduction in preterm births. Some other studies found no association between gum disease and pregnancy complications.
This year, researchers at the University of Pennsylvania Health System, reported in the American Journal of Obstetrics and Gynecology that adjusting for confounding factors appears to eliminate any correlation between gum disease and pregnancy outcomes.
Finnish researchers reported in July 2007 in the journal Atherosclerosis that exposure to one type of bacteria that causes gum disease appears to be associated with a doubling of the risk that women will suffer from another major cause of disability claims–stroke.
For the most part, women appear to be more conscientious than men about seeking dental care, according to researchers.
When researchers at the National Center for Health Statistics reviewed 2003-2004 data from the National Health and Nutrition Examination Survey, they found that only 25% of the women included had untreated cavities, compared with 30% of the men.
But even some women with higher incomes skimp on dental care: 25% of women with family incomes over 300% of the federal poverty level who were included in the national health survey said they had not seen a dentist in more than a year, and 6.5% said they had not seen a dentist in more than 5 years.
Marketers suggest the following strategies for ensuring that women have adequate dental insurance, and incentives to get routine preventive care no matter what kind of insurance they have:
–Let employer benefits managers and employees themselves know about the research suggesting gum disease may be associated with conditions that can affect women’s overall health.
–Encourage employers to offer plans that provide extra care for pregnant women, or for all members who appear to have gum disease in need of aggressive treatment.
–Tell employers and individual clients that employees who are eligible for COBRA health coverage continuation benefits can use COBRA–and the new federal 9-month COBRA subsidy–to continue dental coverage.
–Periodically remind women coming in for retirement planning advice or other financial advice that taking care of their teeth is a good investment.
–Offer reputable voluntary or employer-paid dental discount programs to employers who feel that, given the state of the current economy, they cannot afford to pay for employee dental benefits, and to individual women who have no access to group dental benefits and no ability to pay for insured coverage.
–Look for ways to include oral health in health coaching and wellness incentive programs.