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Comparative Study
. 2012 Jul 9:12:20.
doi: 10.1186/1472-6831-12-20.

Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models

Monica Chaudhari  1 , Rebecca Hubbard, Robert J Reid, Ronald Inge, Katherine M Newton, Leslie Spangler, William E Barlow
Affiliations
Comparative Study

Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models

Monica Chaudhari et al. BMC Oral Health. .

Abstract

Background: About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental care utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes.

Methods: Data included secondary enrollment and demographic data from Washington Dental Service (WDS) and Group Health Cooperative (GH), clinical data from GH, and dental-utilization data from WDS claims during 2002-2006. Dental and medical records from WDS and GH were linked for enrollees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups.

Results: We found that adults with diabetes had lower odds of visiting a dentist (OR = 0.74, p < 0.001). Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxis (OR = 0.77), fillings (OR = 0.80) and crowns (OR = 0.84) (p < 0.005 for all) and higher odds of receiving periodontal maintenance (OR = 1.24), non-surgical periodontal procedures (OR = 1.30), extractions (OR = 1.38) and removable prosthetics (OR = 1.36) (p < 0.001 for all).

Conclusions: Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes.

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Figures

Figure 1
Figure 1
Flow-chart for study cohort.
Figure 2
Figure 2
Pre- and post-matching covariate balance.
See this image and copyright information in PMC

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