When workplace dental plans are designed to promote employees’ proactive oral health, it can reduce overall benefits plan expenditures, including the cost of medications.
Forty per cent of adults are at high risk of poor oral health, including adults with special needs, people with type 2 diabetes, the elderly or frail and those with mental-health disorders, says Ross Perry, chief executive officer of CHX Technologies Inc., noting periodontal inflammation in the general population is typically around 60 per cent. Next to hypertension, gum inflammation is the most prevalent disease, yet it isn’t addressed by a typical dental plan, he adds.
If an individual can stay on top of periodontal inflammation, they’ll have less risk of depression, systemic inflammation and unstable diabetes, says Perry. “We’ve always looked at the dental plan as preventing cavities, but the real unmet need is treating gum disease. If you can do that, workers will be far better off.”
Tearing down the wall
Benefits plans are typically set up in silos, which makes it challenging for employees to get the help they need for their oral health, he says, suggesting employers design a benefits package that uses the dental plan to reduce drug plan costs.
For example, periodontal inflammation can cause employees with type 2 diabetes to have more unstable disease symptoms, which may translate to more sick days, doctor visits and drug plan utilization.
“If employees’ gum disease continues to go untreated, employers will see more sickness and spend more on drugs through their plans then they would have if they were more proactive about employee oral health,” says Perry.
A recent study found a better handle on oral inflammation and gum disease can reduce the number of medications a person with diabetes is taking by at least one prescription, he adds.
“If they’re taking three, we can reduce that to two. And we can reduce the blood sugar levels by 10 per cent. That is a dramatic reduction in the quality of life for a person with diabetes, but we’re not connecting those dots just yet because we have the silos of the drug and dental plans.”
Sandeep Kakan, director of pensions and benefits at Unifor, agrees with the link between different parts of the benefits plan. “When one’s oral health suffers, they feel embarrassed about their health or shape of their teeth [and] it can trigger social anxiety. Employers should have a balance between different benefits streams to make an effective impact on members’ health and well-being and productivity in the workplace.”
And if employees understand the connection between oral health and overall well-being, they’ll be more likely to take the former seriously, particularly if the help they need is available through their benefits plans.
“There’s a need for more education on oral health and the link to physical health in the workplace,” says Perry.
Removing barriers, using benchmarks
Also, when benefits plan members face a barrier in accessing their dental plans, it can increase the burden on other employer-sponsored benefits.
Unifor’s equitable intergenerational policies mean its members’ benefits plans are free from barrier-inducing co-insurance, lifetime maximum restrictions or restrictive access for dependants. On the other hand, a typical benefits plan will often cap orthodontic coverage for eligible dependant children at 50 per cent co-insurance, so if the benefit is $3,000, it would pay $1,500 for the entire lifetime.
“That doesn’t exist in the staff plan,” says Kakan. “Members and their dependants are able to get corrective action taken as recommended by their orthodontic provider.”
In order to identify options to improve existing dental plans in its contract agreements, Unifor conducts member surveys and obtains trends analyses and usage data for each contract, he says. For example, the union was able to use data points to find cost savings within one employer’s existing group benefits renewal that was used to expand access to the dental plan for non-union and management staff.
Unifor also benchmarks its contracts against industry standards and uses the data to explain to employers how their plan is currently impacting members. Most employers are receptive to hearing about issues — such as stigma, social anxiety, absenteeism or presenteeism — that are affecting their employees, says Kakan.
Benchmarking also helps employers recognize the support areas they should focus on to help reduce the overall cost of their plans, he adds, suggesting they benchmark at least annually to be aware of changing trends. “If they’re not offering a certain dental benefit that has become a standard, they’ll be at a disadvantage in this competitive [employment] landscape.”
Lauren Bailey is an associate editor at Benefits Canada.