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Sjogren's Disease - Cost Benefit Analysis

Discussion in 'Dental' started by Case Manager, May 16, 2008.

  1. Case Manager

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    I am looking for some literature supporting a patient's health insurance paying for full cast captec crowns due to amelogenesis due to xerostomia from Sjorgren's syndrome. Cost - Benefit of dental restoration to maintain mandible, nutritional status, general health vs. surgical intervention for disease process. Thanks very much.
     
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  3. aphistis

    Moderator Emeritus 10+ Year Member

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    I don't know of any literature of the sort you're requesting.

    This is a very strange question based on the limited information you've provided. Sjogren's has no effects whatsoever on amelogenesis. If the teeth are decayed, restoring them would invoke the usual set of risks and benefits, but in a Sjogren's patient you'd have to worry about how well the restoration are maintained in the xerostomic environment afterward, because in that scenario it'd be very easy to encounter widespread restorative failure due to secondary caries and end up right back where you started. If the teeth are healthy, there's absolutely no reason to do anything except continue taking good care of them.
     
  4. armorshell

    armorshell One Man Freak Show
    Physician Dentist Moderator Emeritus 10+ Year Member

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  5. rarm1

    rarm1 Senior Member
    SDN Advisor 10+ Year Member

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    Hello,
    I see many patients with xerostomia for different reasons - radiation, medications, other systemic diseases including autoimmune diseases like trhe sicca complex.

    Sjorgrens does not cause alter amelogenesis... it causes salivary gland problems with dry mouth... this does not cause caries either... The diet the patient has... especially sodas and othe acid drinks, th lack of oral hygiene, the lack of routine dental care will lead to caries and loss of teeth... BUT no one has died from not having teeth. INFECTED TEETH can lead to systemic problems.

    Esthetics, self esteem will improve with teeth. It is easier to chew with teeth.

    cost benefit - based on patient compliance, motivation...
    the cheapest to avoid infection will be extractions... but not the best treatment... treatment most be individualized
    with no motivationn crowns, retorations can fail

    coverage - most/all medical insurance will not cover dentistry due to decay... some may cover loss of teeth due to some major disease

    hope this helps
     

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