Many consumers haven’t heard of the “mouth-body” connection,
but Aetna officials are banking on it. By enrolling more than 600,000 pregnant women, heart
disease patients and others in a special intervention program, the insurance and health benefits company
hopes to show that medical costs can be undercut by attacking gum disease earlier and more aggressively.
The enrollees’ at-risk medical status qualifies them for 100 percent coverage
of several not-so-pleasant, but vital procedures, such as deep cleaning of diseased gums.
(Aetna plans typically cover 50 to 80 percent of periodontal treatment.) The goal, officials say,
is to reduce costly medical complications by enticing people to clean up their mouths.
“We thought if we could eliminate the out-of-pocket expense for these services,
it might help a patient to be more compliant,” says Dr. Mary Lee Conicella, national director of clinical operations
for Aetna Dental. “We feel strongly that in the long run they will have fewer complications dentally and medically.”
The Aetna program, which also automatically enrolls those with diabetes or a stroke history,
is only one such insurance initiative to emerge in recent years, amid a growing body of research delving into this mouth-body connection.
Cigna Dental has launched a similar program—also for those enrolled in both their medical and dental products. Officials say
that by attacking gum disease more aggressively, they hope to thwart potentially inflammatory fallout, including heart disease
and preterm delivery of infants.
According to the American Academy of Periodontology, more than one
in three adults 30 and older have gum disease, also known as periodontitis. And some Americans are
starting to understand the potential medical risks of unhealthy gums. Nearly 40 percent said they
had heard about recent research into the mouth-body connection, according to a 2007 consumer survey
conducted by the National Association of Dental Plans.
For employers, though, identifying and reaching those vulnerable individuals can be challenging.
To start, a company might use a different insurance provider for medical and dental benefits.
Plus, even proponents of attacking gum problems to address medical issues acknowledge that
researchers are still unraveling exactly how, and to what extent, healing gums improves
some conditions.
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