Discontinuation of dental care and systemic diseases of persons in need of long-term home care : an observational study from the InSEMaP project with German health insurance claims data

Abstract

Introduction: Impaired oral health poses a risk factor for several systemic diseases. The aim of this study was to investigate associations between the discontinuation of regular dental care use and several systemic diseases among persons with an incident long-term home care need.

Methods: Using German health and long-term care insurance data from the DAK-Gesundheit of persons aged ≥ 60 years, we partitioned the observational period into a baseline (2015–2016), an exposure (2017–2018), and a follow-up period (2019–2020). We selected persons who regularly visited the dentist in 2015–2016 with incident and lasting need for long-term home care from 2017 on. We compared persons who discontinued dental care (DDC group) with those who continued to regularly visit the dentist (CDC group) regarding the occurrence of several systemic diseases. We applied entropy balancing and analyzed the probability for each systemic disease using weighted logistic regressions.

Results: We selected n = 11,767 persons in the CDC and n = 1,477 in the DDC group. We found slightly higher odds for dementia in the DDC than the CDC group, but there were no significant differences between groups regarding the occurrence of: type 2 diabetes, cardiovascular disease, chronic obstructive pulmonary disease, pneumonia, oral cancer, and rheumatoid arthritis.

Conclusion: The discontinuation of regular dental services was associated with dementia. However, the studied conditions and the impact of a discontinuation of dental care on general health likely progress slowly and the direction and cause of the association remains unclear.