Diabetes in Long Term Care
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Diabetes in dependent adults is pervasive. Many are suffering needlessly because their oral health is contributing to glucose management. Dental hygienists in most states are unable to care for these people without a prescription from a dentist. It's an unnecessary hurdle.
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Diabetes in Long Term Care
- 1. Diabetes Glucose management affected by oral health
- 2. “Analysis indicated that periodontal care appeared to have a positive effect on the cost of medical care… Members with periodontal treatment also had lower retrospective risk for their chronic condition (diabetes, CAD, CVD).” -Mary Lee Conicella, DMD, FAGD, National Director of Clinical Operations for Aetna Dental.
- 3. 2-3X Older, more diverse population and longer lifespans contribute to increase. www.cdc.gov/media/pressrel/2010/r101022.html
- 4. Among U.S. residents aged 65 years and older, 10.9 million, or 26.9%, had diabetes in 2010. 27 %
- 5. Pre Diabetes in Adults 50% of adults aged 65 years or older had pre-diabetes 50 %
- 6. The Big Five Six
- 7. The Sixth Complication Periodontal Disease
- 8. Diabetes has an effect on the microvasculature
- 9. Gums are filled with microvasculature
- 11. Diabetic Wounds are hard to heal The damage to the capillary vessels is one reason.
- 12. Periodontal Disease Surface Area
- 13. The hand as a percentage of Whole body by shape 2.5% for the lean group 2.3% for overweight people Journal of PHYSIOLOGICAL ANTHROPOLOGYVol. 26 (2007)
- 14. Image courtesy of Patterson Technology
- 15. 200 cm2 chronic wound 1% total surface area of the human body Invisible Painless No fever Image from: www.burnexperts.com/burnseverity.htm
- 16. Christopher Reeves Died of “bed sore”
- 17. Periodontal Treatment improved Glycemic Control The effect of periodontal therapy on the improvement of glycemic control in patients with type 2 diabetes mellitus: A randomized controlled clinical trial. IntJ Diabetes DevCtries. 2008
- 18. Periodontal Treatment improved Glycemic Control Effect of non-surgical periodontal therapy on patients with type 2 diabetes mellitus. Folia Med (Plovdiv). 2007
- 20. Pain
- 21. Chewing
- 24. Oral Cancer
- 25. Self esteem
- 27. One third of all elderly have “difficulty chewing or biting some foods” 20+ teeth needed for good nutrition
- 28. Periodontal Treatment improved Glycemic Control Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol. Sep;74(9) 2003
- 29. Full-mouth tooth extraction resulted in an improvement in glycemic control among diabetic patients. J Periodontal Res. 2010 Dec;45(6)
- 30. Blood Sugar and Exercise 1,154 people entered their BG numbers on BigBlueTest.org (you can enter your numbers any time you want, even if it's not World Diabetes Day!)
- 32. Is exercise a nutrient?
- 33. The Oral Systemic Link “The review of oral health linkages with general health reveals implications for the clinical practice of both medicine and dentistry. The recognition of well known and established signs and symptoms of oral diseases may assist in the early diagnosis and prompt treatment of some systemic diseases and disorders.”
- 34. Saves everyone!
- 35. Insurance saves money! 3 year study 3500 people with diabetes
- 36. Insurance saves money! Periodontal Treatment Saved $2,483 in medical costs
- 37. Insurance saves money! Periodontal Treatment Saved $2,483 in medical costs Per Year
- 38. $2,483 By managing the risk, each person with diabetes saved over $2K in other medical expenses per year! Research from CIGNA Supports Potential Association between Treated Gum Disease and Reduced Medical Costs for People with Diabetes
- 39. To Summarize
- 40. Conclusion Dental hygienists cannot work in Long Term Care facilities unless there is also a dentist there to “oversee” them. Dental hygienists risk their license if they brush someone’s teeth without a prescription by a dentist to do so.
- 41. Find out the laws restricting dental hygienists in your state! Mandating a dental hygienist on the staff of all Medicaid funded care facilities can save millions of dollars a year just in people with diabetes.
- 42. Credits PowerPoint designed by Cross Link Presentations, LLC Presentation design Shirley Gutkowski, RDH, BSDH, FACE crosslinkpresent@aol.com ScriptShirley Gutkowski, RDH, BSDH, FACE Photos: Dreamstime, Gutkowski, StoneCharacters: PresenterMedia Copyright 2011 Exploring Transitions, LLC
Notes de l'éditeur
- http://www.cdc.gov/media/pressrel/2010/r101022.htmlNumber of Americans with Diabetes Projected to Double or Triple by 2050.With the previlance of diabetes increasing learning how to mitigate the disease becomes a much higher priority.
- http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
- http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
- Diabetes has historically had five major adverse outcomes:Cardiovasuclar diseaseKidney failureBlindnessNeuropathyAnd ulcers in the feet and skin (Diabetes is the leading cause of kidney failure, nontraumaticlowerlimb amputations, and new cases of blindness among adults in the United States.)Periodontal disease has often been listed as a sixth, however today there is a lot of discussion as to which really came first – diabetes or periodontal disease. The two diseases share etiology.
- Periodontal disease is an unseen infection, although you may smell it.The disease abuses the body’s infection control system, and increases inflammatory markersPoor glucose management affects periodontal disease and periodontal disease – like any other untreated infection – makes glucose management difficult.
- One of the major effects of high blood glucose levels is on the microvasculature. The tiny blood vessels, capillaries, break down when too much sugar is in the blood, and it’s hard for the body to repair the blood vessels under those high glucose conditions. These tiny blood vessels bring nutrients to tissues far away from the major bold vessels, and they also bring oxygen necessary for tissues to heal.
- http://www.biosbcc.net/doohan/sample/images/CO%20and%20MAP/0303lymph.jpgThe gums are densely packed with capillary blood vessels. Once those blood vessels are damaged, the mechanism to fight off the bacteria is compromised. The while blood cells that attack bad bacteria cannot get to their targets. The bacteria form a biofilm and none of the chemistry designed to get rid of bacteria is ineffective. The breakdown in the capillaries also allow oral bacteria to enter the blood stream and enter into already formed arterial plaques.
- When the blood sugar is too high, there’s also a higher amount of sugar in the saliva. The bacteria survive on the sugar and their lives are complete. People in care facilities are also on a number of medications that stop saliva production, increasing the concentration of glucose in the saliva. The sugar doesn’t act directly on the teeth, the sugar feeds the bacteria, and when there’s an inadequate amount of saliva the waste products produced by the bacteria is not diluted or buffered.
- Journal of PHYSIOLOGICAL ANTHROPOLOGYVol. 26 (2007) , No. 4 pp.475-483Determination of Hand Surface Area by Sex and Body Shape using AlginateJoo-Young Lee1), Jeong-Wha Choi2)3) and Ho Kim4)
- The soft tissue wall of the pocket is an infected wound site. Imagine if this wound was on the skin, visible?What would you do?How would you treat it? Would you add food to it, keep it dark and warm?
- In a person with 20 teeth the wound is about 1% of the surface area of the human body. No matter what size it’s important to keep the growing biomass down. Brush and floss are part of it. Adding xylitol is another. Xylitol makes it hard for the bacteria to make that sticky coating that keeps them safe.They also eventually starve because they cannot survive on xylitol although they prefer it.
- You all know that bed sores are a problem, and that on occasion a resident will die from a bed sore, as Christopher Reeves the actor did. The wound called periodontal disease is very similar. When people with diabetes die, they often die of cardiovasular disease, and that is often what is entered into the death record. The reason for the CVD is diabetes, so they really die of diabetes complications. It won’t be much longer that periodontal disease complications will be an entry on some death certificates.
- The dental hygienists of PrevMed are experts in treating periodontal disease but they need your help. The biofilm that grows on the teeth needs to be removed or disrupted every day so it doesn’t take hold. We realize that you sometimes you cannot brush and floss the resident’s teeth the way you would your own. Using the xylitol products and the other products we supply helps make it harder for the bacteria to accumulate and the residents like it.
- By reducing the biofilm on the teeth as often as possible you’ll be helping the resident maintain better glucose control and have fewer problems associated with diabetes. We can help show you the best approach for each resident. Some days you won’t get it done, but if you try every day you’ll be successful more often
- Teeth do a lot of things. And when things go wrong they can go very wrong. Teeth are important for chewing, that’s obvious. They are also important for maintaining self esteem, and for sociological wellbeing. The teeth, though, can harbor bacteria that damage the teeth, or the entire system.
- http://www.hqlo.com/content/pdf/1477-7525-8-118.pdfAssociation between perceived chewing abilityand oral health-related quality of life in partiallydentate patients
- http://www.hqlo.com/content/pdf/1477-7525-8-118.pdfTeeth are important for nutrition. And the number of teeth impacts nutrition greatly. Replacing the teeth with dentures helps but brings about other problems. And dentures need to be cleaned too.
- You may never get a reading that’s perfect but if you keep at it you’ll start to notice that not only the air quality is improved in the room, the resident will feel better. If you noticed bleeding when you brushed their teeth, it’ll be less. The studies that looked at glycemic control with respect to oral health and treatment of periodontal disease are united.
- Most of us want to keep our teeth, we know that having teeth increases quality of life, it also increases nutrition. Not many people what to have their teeth taken out. Although sometimes that’s the best option, minimally invasive dentistry. J Periodontal Res. 2010 Dec;45(6):741-7. doi: 10.1111/j.1600-0765.2010.01294.x.The effect of full-mouth tooth extraction on glycemic control among patients with type 2 diabetes requiring extraction of all remaining teeth: a randomized clinical trial.Khader YS, Al Habashneh R, Al Malalheh M, Bataineh A.SourceDepartments of Public HealthCommunityMedicineFamily Medicine, Jordan University of Science and Technology, Irbid, Jordan.AbstractBACKGROUND AND OBJECTIVE:Several studies have shown that periodontitis can complicate the severity of diabetes by worsening the degree of glycemic control. The purpose of this study was to determine the effect of full-mouth tooth extraction on glycemic control among type 2 diabetic patients.MATERIAL AND METHODS:A total of 58 patients with type 2 diabetes mellitus and advanced periodontitis who were requiring extraction of all remaining teeth were randomized consecutively into treatment (full-mouth tooth extraction) and control groups (no treatment). Eight patients were lost to follow-up or reported use of antibiotics, leaving 50 patients to be included in the analysis. All patients had all their remaining teeth in a hopeless condition. Relevant data were collected, and glycosylated hemoglobin (HbA(1c) ) and fasting blood glucose levels were measured at baseline and at follow-up times of 3 and 6 mo.RESULTS:At baseline, the mean (SD) HbA(1c) level was 8.6% (1.24) in the treatment group and 7.7% (0.87) in the control group. In the treatment group, the mean HbA(1c) level decreased significantly from 8.6% at baseline to 7.4% after 3 mo of denture treatment, and continued to decrease to 7.3% after 6 mo. In the control group, the mean HbA(1c) decreased from 7.7% at baseline to 7.5% after 3 mo, and remained almost the same after 6 mo. After adjusting for the baseline HbA(1c) , the mean reduction in HbA(1c) after 3 mo in the treatment group [1.23% (0.79)] was significantly higher than the mean reduction in the control group [0.28% (0.87)].CONCLUSION:Full-mouth tooth extraction resulted in an improvement in glycemic control among diabetic patients. Large-scale multicentre clinical trials are needed to confirm the current evidence.
- Lowering glucose numbers can be achieved in a number of ways. Altering diet, maintaining medication, or exercise are often cited.The BG numbersThe memories and the excitement of 2009 were still fresh in everyone's mind. And it was exciting all over again to discover the impact that 14 minutes of exercise can have on blood sugars.1,154 people entered their BG numbers on BigBlueTest.org (you can enter your numbers any time you want, even if it's not World Diabetes Day!):* The median BG before exercising was 133.6 mg/dL* The median BG after exercising was 111.6 mg/dLThe median change was -19 mg/dL (a 14% drop)157 people entered their BG numbers on GranPruebaAzul.org (in Spanish):* The median BG before exercising was 129 mg/dL* The median BG after exercising was 110 mg/dLThe median change was -17 mg/dL (a 13% drop)
- Studies like this make it seem as though exercise is a nutrient. What do you think about that (either ask the audience or give your own opinion about this comment)?
- Research from CIGNA Supports Potential Association between Treated Gum Disease and Reduced Medical Costs for People with DiabetesSUNRISE, Fla., March 29, 2011 - The results from a new CIGNA study support that there is a potential association between treated periodontal (gum) disease and reduced medical costs for patients with diabetes. The findings of the three-year claims study were presented during a recent meeting of the International Association for Dental Research (IADR) in San Diego.The study was presented by Dr. Clay Hedlund, a CIGNA dental director, Dr. Marjorie Jeffcoat, Dean Emeritus and professor, University of Pennsylvania School of Dental Medicine, Dr. Robert Genco, a SUNY Distinguished Professor, University at Buffalo Schools of Dental Medicine, and Dr NipulTanna, clinical assistant professor, University of Pennsylvania School of Dental Medicine. Drs. Jeffcoat and Genco are members of the CIGNA Dental Clinical Advisory Panel.* IADR is a non-profit organization dedicated to advancing research and increasing knowledge to improve oral health worldwide.CIGNA's Dr. Hedlund said the study corroborates the results of CIGNA's prior research, presented at the IADR meeting in 2009, in support of a possible association between the treatment of gum disease and lower medical costs in the treatment of diabetes. In the current study, patients who were treated for gum disease in the first year of the study and then received regular maintenance care thereafter had lower medical costs than those patients who had previously been treated for gum disease but did not receive regular maintenance care. On average, medical costs were $2,483 per year lower, or 23 percent less, for patients with diabetes who had proper gum disease treatment.“With the increase in the prevalence of diabetes, and great concern for our ever-increasing medical costs, this study suggests that periodontal therapy may help reduce the disease burden, as well as medical costs of treatment for patients with diabetes,” said Dr. Robert Genco.“The link between periodontal disease and diabetes has been firmly established and the association is a concern," said Dr. Marjorie Jeffcoat. “Periodontal disease can place individuals with diabetes at greater risk for diabetic complications, including mortality from cardiovascular disease and diabetic nephropathy. Advancing our understanding on how treatment for gum disease can affect the health of people with diabetes will help lead to the creation of evidence-based treatment standards that could benefit millions of people and help reduce medical costs at the same time.”Dr. Clay Hedlund noted, “These results suggest that treating gum disease has benefits beyond better oral health and may also help to control medical costs for some patients as well. We are pleased to be part of the dental community’s ongoing research into the links between good oral health and good overall health.”About the ResearchThe length of the study period was three full years, 2006 to 2008. It included an examination of medical and dental claims of over 46,094 individuals aged 18-62 who were enrolled in both CIGNA medical and CIGNA dental plans. The medical cost analysis included 3,449 patients from this group who received treatment for diabetes. These patients were presumed to also have had gum disease since they had received periodontal (gum) therapy at some point.Two different groups of patients with gum disease were then compared. Individuals in the first group received initial treatment for gum disease during the first (baseline) year of the study and received regular maintenance care thereafter (1,355 patients). Individuals in the second group received treatment for periodontal disease prior to the baseline year, and did not receive regular maintenance care during the study period (2,094 patients).Lower medical costs among patients being treated for diabetes were observed in the group who received periodontal treatment in the first year and then regular maintenance care thereafter. Conversely, medical costs were higher in the group of patients who received treatment prior to the baseline year and did not receive regular maintenance care thereafter. These medical cost differences averaged $2,483 per patient in 2008. These results are part of ongoing studies at CIGNA.CIGNA is an industry leader in providing integrated medical and dental plans to address the emerging association between periodontal disease and chronic medical conditions and between periodontal disease and pregnancy. In 2006, CIGNA launched its Oral Health Integration Program, the first program of its kind to be offered by a health services company. Through this program, CIGNA dental plan customers with certain health care conditions, or those who are pregnant, are eligible to receive 100 percent reimbursement for out-of-pocket costs associated with periodontal scaling and root planing and periodontal maintenance. In addition, expectant mothers may receive extra dental cleanings as needed during pregnancy. The program was expanded earlier this year to include more people and coverage for more conditions. These integrated programs are designed to help eliminate cost as a barrier to seeking appropriate treatment for gum disease and ultimately improve health.*About the CIGNA Dental Clinical Advisory Panel – The CIGNA Dental Clinical Advisory panel helps to create innovative approaches to new technologies, medical/dental integration and evidence-based strategies. Organized by CIGNA, this independent panel consists of leaders in the dental profession, many of whom are published and have served in leadership roles within their specialty or the American Dental Association. Several panel members have current academic appointments in major schools of dentistry, including the University of PA, Tufts, SUNY, and UCLA.
- Research from CIGNA Supports Potential Association between Treated Gum Disease and Reduced Medical Costs for People with DiabetesSUNRISE, Fla., March 29, 2011 - The results from a new CIGNA study support that there is a potential association between treated periodontal (gum) disease and reduced medical costs for patients with diabetes. The findings of the three-year claims study were presented during a recent meeting of the International Association for Dental Research (IADR) in San Diego.The study was presented by Dr. Clay Hedlund, a CIGNA dental director, Dr. Marjorie Jeffcoat, Dean Emeritus and professor, University of Pennsylvania School of Dental Medicine, Dr. Robert Genco, a SUNY Distinguished Professor, University at Buffalo Schools of Dental Medicine, and Dr NipulTanna, clinical assistant professor, University of Pennsylvania School of Dental Medicine. Drs. Jeffcoat and Genco are members of the CIGNA Dental Clinical Advisory Panel.* IADR is a non-profit organization dedicated to advancing research and increasing knowledge to improve oral health worldwide.CIGNA's Dr. Hedlund said the study corroborates the results of CIGNA's prior research, presented at the IADR meeting in 2009, in support of a possible association between the treatment of gum disease and lower medical costs in the treatment of diabetes. In the current study, patients who were treated for gum disease in the first year of the study and then received regular maintenance care thereafter had lower medical costs than those patients who had previously been treated for gum disease but did not receive regular maintenance care. On average, medical costs were $2,483 per year lower, or 23 percent less, for patients with diabetes who had proper gum disease treatment.“With the increase in the prevalence of diabetes, and great concern for our ever-increasing medical costs, this study suggests that periodontal therapy may help reduce the disease burden, as well as medical costs of treatment for patients with diabetes,” said Dr. Robert Genco.“The link between periodontal disease and diabetes has been firmly established and the association is a concern," said Dr. Marjorie Jeffcoat. “Periodontal disease can place individuals with diabetes at greater risk for diabetic complications, including mortality from cardiovascular disease and diabetic nephropathy. Advancing our understanding on how treatment for gum disease can affect the health of people with diabetes will help lead to the creation of evidence-based treatment standards that could benefit millions of people and help reduce medical costs at the same time.”Dr. Clay Hedlund noted, “These results suggest that treating gum disease has benefits beyond better oral health and may also help to control medical costs for some patients as well. We are pleased to be part of the dental community’s ongoing research into the links between good oral health and good overall health.”About the ResearchThe length of the study period was three full years, 2006 to 2008. It included an examination of medical and dental claims of over 46,094 individuals aged 18-62 who were enrolled in both CIGNA medical and CIGNA dental plans. The medical cost analysis included 3,449 patients from this group who received treatment for diabetes. These patients were presumed to also have had gum disease since they had received periodontal (gum) therapy at some point.Two different groups of patients with gum disease were then compared. Individuals in the first group received initial treatment for gum disease during the first (baseline) year of the study and received regular maintenance care thereafter (1,355 patients). Individuals in the second group received treatment for periodontal disease prior to the baseline year, and did not receive regular maintenance care during the study period (2,094 patients).Lower medical costs among patients being treated for diabetes were observed in the group who received periodontal treatment in the first year and then regular maintenance care thereafter. Conversely, medical costs were higher in the group of patients who received treatment prior to the baseline year and did not receive regular maintenance care thereafter. These medical cost differences averaged $2,483 per patient in 2008. These results are part of ongoing studies at CIGNA.CIGNA is an industry leader in providing integrated medical and dental plans to address the emerging association between periodontal disease and chronic medical conditions and between periodontal disease and pregnancy. In 2006, CIGNA launched its Oral Health Integration Program, the first program of its kind to be offered by a health services company. Through this program, CIGNA dental plan customers with certain health care conditions, or those who are pregnant, are eligible to receive 100 percent reimbursement for out-of-pocket costs associated with periodontal scaling and root planing and periodontal maintenance. In addition, expectant mothers may receive extra dental cleanings as needed during pregnancy. The program was expanded earlier this year to include more people and coverage for more conditions. These integrated programs are designed to help eliminate cost as a barrier to seeking appropriate treatment for gum disease and ultimately improve health.*About the CIGNA Dental Clinical Advisory Panel – The CIGNA Dental Clinical Advisory panel helps to create innovative approaches to new technologies, medical/dental integration and evidence-based strategies. Organized by CIGNA, this independent panel consists of leaders in the dental profession, many of whom are published and have served in leadership roles within their specialty or the American Dental Association. Several panel members have current academic appointments in major schools of dentistry, including the University of PA, Tufts, SUNY, and UCLA.
- Research from CIGNA Supports Potential Association between Treated Gum Disease and Reduced Medical Costs for People with DiabetesSUNRISE, Fla., March 29, 2011 - The results from a new CIGNA study support that there is a potential association between treated periodontal (gum) disease and reduced medical costs for patients with diabetes. The findings of the three-year claims study were presented during a recent meeting of the International Association for Dental Research (IADR) in San Diego.The study was presented by Dr. Clay Hedlund, a CIGNA dental director, Dr. Marjorie Jeffcoat, Dean Emeritus and professor, University of Pennsylvania School of Dental Medicine, Dr. Robert Genco, a SUNY Distinguished Professor, University at Buffalo Schools of Dental Medicine, and Dr NipulTanna, clinical assistant professor, University of Pennsylvania School of Dental Medicine. Drs. Jeffcoat and Genco are members of the CIGNA Dental Clinical Advisory Panel.* IADR is a non-profit organization dedicated to advancing research and increasing knowledge to improve oral health worldwide.CIGNA's Dr. Hedlund said the study corroborates the results of CIGNA's prior research, presented at the IADR meeting in 2009, in support of a possible association between the treatment of gum disease and lower medical costs in the treatment of diabetes. In the current study, patients who were treated for gum disease in the first year of the study and then received regular maintenance care thereafter had lower medical costs than those patients who had previously been treated for gum disease but did not receive regular maintenance care. On average, medical costs were $2,483 per year lower, or 23 percent less, for patients with diabetes who had proper gum disease treatment.“With the increase in the prevalence of diabetes, and great concern for our ever-increasing medical costs, this study suggests that periodontal therapy may help reduce the disease burden, as well as medical costs of treatment for patients with diabetes,” said Dr. Robert Genco.“The link between periodontal disease and diabetes has been firmly established and the association is a concern," said Dr. Marjorie Jeffcoat. “Periodontal disease can place individuals with diabetes at greater risk for diabetic complications, including mortality from cardiovascular disease and diabetic nephropathy. Advancing our understanding on how treatment for gum disease can affect the health of people with diabetes will help lead to the creation of evidence-based treatment standards that could benefit millions of people and help reduce medical costs at the same time.”Dr. Clay Hedlund noted, “These results suggest that treating gum disease has benefits beyond better oral health and may also help to control medical costs for some patients as well. We are pleased to be part of the dental community’s ongoing research into the links between good oral health and good overall health.”About the ResearchThe length of the study period was three full years, 2006 to 2008. It included an examination of medical and dental claims of over 46,094 individuals aged 18-62 who were enrolled in both CIGNA medical and CIGNA dental plans. The medical cost analysis included 3,449 patients from this group who received treatment for diabetes. These patients were presumed to also have had gum disease since they had received periodontal (gum) therapy at some point.Two different groups of patients with gum disease were then compared. Individuals in the first group received initial treatment for gum disease during the first (baseline) year of the study and received regular maintenance care thereafter (1,355 patients). Individuals in the second group received treatment for periodontal disease prior to the baseline year, and did not receive regular maintenance care during the study period (2,094 patients).Lower medical costs among patients being treated for diabetes were observed in the group who received periodontal treatment in the first year and then regular maintenance care thereafter. Conversely, medical costs were higher in the group of patients who received treatment prior to the baseline year and did not receive regular maintenance care thereafter. These medical cost differences averaged $2,483 per patient in 2008. These results are part of ongoing studies at CIGNA.CIGNA is an industry leader in providing integrated medical and dental plans to address the emerging association between periodontal disease and chronic medical conditions and between periodontal disease and pregnancy. In 2006, CIGNA launched its Oral Health Integration Program, the first program of its kind to be offered by a health services company. Through this program, CIGNA dental plan customers with certain health care conditions, or those who are pregnant, are eligible to receive 100 percent reimbursement for out-of-pocket costs associated with periodontal scaling and root planing and periodontal maintenance. In addition, expectant mothers may receive extra dental cleanings as needed during pregnancy. The program was expanded earlier this year to include more people and coverage for more conditions. These integrated programs are designed to help eliminate cost as a barrier to seeking appropriate treatment for gum disease and ultimately improve health.*About the CIGNA Dental Clinical Advisory Panel – The CIGNA Dental Clinical Advisory panel helps to create innovative approaches to new technologies, medical/dental integration and evidence-based strategies. Organized by CIGNA, this independent panel consists of leaders in the dental profession, many of whom are published and have served in leadership roles within their specialty or the American Dental Association. Several panel members have current academic appointments in major schools of dentistry, including the University of PA, Tufts, SUNY, and UCLA.
- This course is copyrighted by Exploring Transitions, LLC and is available for use by PrevMed. Only a small number of copies are allowed due to restrictions on the photographs. Contact Shirley Gutkowski if this is past year 2018. crosslinkpresent@aol.com.