Dental restorative treatment expenditure and resource utilization in patients with chronic kidney disease: A nationwide population-based study

J Dent Sci. 2017 Sep;12(3):275-282. doi: 10.1016/j.jds.2016.12.006. Epub 2017 Apr 23.

Abstract

Background/purpose: There is a variety of pathological alterations occurring in the oral cavity are strongly associated with chronic kidney disease (CKD) or CKD therapy. The aim of this study is to conduct a retrospective analysis to examine the possible correlation between the dental restorative treatment modalities and the progression of kidney disease in CKD population.

Materials and methods: A total of 10,457 individuals were divided into three groups: (HC) group (n = 1438), high risk (HR) group (n = 3392), and CKD group (n = 5627). HR group were defined for those with an eGFR ≥60 (mL/min/1.73 m2) in addition to fulfilling one of the following requirements: (1) being diagnosed diabetes mellitus (DM), hypertension, or cardiovascular disease; (2) having a family member diagnosed with CKD or receiving dialysis treatment. Demographic characteristics, dental restorative treatment utilization and expenditures, including amalgam filling, composite resin filling on anterior teeth or posterior teeth, were analyzed retrospectively (2000-2008) among these groups using a nationwide database.

Results: The utilization and expenditures for various restorative treatments were significantly different among investigated groups, and the health insurance usage exhibited an inverse relationship with CKD stages, especially at CKD stages 4 and 5. A sustained decline in utilization and expenditures for restorative treatment was associated with the deterioration of kidney function. The lowest usage of these restorative modalities was noted in the CKD group and a marked difference was noted among investigated groups.

Conclusion: The findings do, however, provide indirect evidence that if patients with progressive renal failure and receive less dental care.

Keywords: dental amalgam; dental care; dental insurance; dental restoration.