Preventive care pays off for employers as well as patients, according to Guardian Life Insurance. The company’s Fifth Annual Workplace Benefits Study, “Dental Benefits: A Bridge to Oral Health & Wellness,” found that employer groups with higher utilization of preventive dental care over a six-year period (at least 13% above average) experienced an 86% reduction in the use of major dental services in subsequent years for a net savings of 16% on dental claims costs.
Meanwhile, dental plan members who received regular preventive care such as an annual oral exam and cleaning required fewer major dental services and experienced lower out-of-pocket costs over a three-year period. Members with annual preventive care for at least two consecutive years had a $90 decrease in claim costs in the third year, while members with no preventive care experienced an average increase of $720 in claim costs.
Older adults see even greater benefits with preventive care. Plan members over the age of 55 who had annual exams and cleanings during the study period decreased their use of major dental services and had 3% lower out-of-pocket costs. In contrast, those 55 and older who did not receive annual preventive care had a 15% increase in out-of-pocket costs.
Overall, plan members who go at least two years without preventive care were 55% more likely to reach their dental plan maximum compared to those who received annual preventive care. Also, 23% of plan members who reach their annual maximum tend to reach it again the following year, and 7% hit the maximum in three or more consecutive years. On average, plan members’ dental claim costs are four times higher in years when they hit their maximum.
The study also found that one in four working Americans with dental benefits did not have an exam or cleaning in the prior year, and one in five had not received any preventive care in the previous two years. While a variety of factors contribute to this low utilization of benefits, Guardian said that a lack of understanding about the importance of regular dental care in maintaining overall health is a major barrier.
Plan members who receive annual preventive care are more likely to avoid serious oral health problems that require more costly treatment later. Many members who require significant dental work and come close to their annual plan maximum often delay treatment to the following year when their annual plan maximum is resent, risking deterioration of their oral health while they postpone treatment.
Yet Guardian says that many members who reach their annual dental plan maximum do improve their oral hygiene habits, with 56% of members who reached their maximum increasing their preventive care and receiving at least one exam and cleaning in the next several years.
Dental plans with greater coverage tend to encourage higher utilization of preventive care, Guardian says. Members whose plans allow more preventive care, higher co-insurance levels, and lower copays are more likely to get annual exams and cleanings than members in more limited dental plans.
Also, higher out-of-pocket costs and reduced benefits lead many members to alter their dental care. According to Guardian, four in 10 working adults with dental benefits skip or delay dental care when their out-of-pocket costs rise due to changes in their employer-based dental plans.
Guardian further notes that regular preventive care helps reduce out-of-pocket costs for most consumers while improving oral health by enabling earlier diagnosis of potentially serious conditions, especially among those at higher risk of oral disease. Programs that encourage annual exams, cleanings, and x-rays can positively impact preventive care utilization, the company says, leading to a healthier and happier workforce.
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