Periodontal disease cost U.S. $154B in 2018

Periodontal disease comes with a high cost: The U.S. lost $154.1 billion in 2018 due to the condition, according to an analysis published on May 30 in the Journal of Periodontology. The loss was even worse in Europe, where periodontal disease cost the region nearly 158.6 billion euros ($194 billion U.S.).

The study analyzed direct and indirect economic burdens of periodontal disease in the U.S. and 32 European countries by looking at global health, dental, and periodontal expenditures. The international team of authors chose 2018 because it is the most recent year with comprehensive data available.

"These results show that the economic burden of periodontal disease is significant and its indirect costs are impactful," wrote the authors, led by João Botelho, a periodontology researcher at Instituto Universitário Egas Moniz in Almada, Portugal.

To understand the total costs of periodontal disease, the authors studied actual disease costs and estimated costs related to productivity losses and oral consequences. They used data from the World Health Organization, the Statistical Office of the European Communities, the International Labour Organization, and the Organization for Economic Cooperation and Development.

Because it wasn't possible to learn the percentage of periodontal expenditures in most countries, the authors estimated that number at 3.45%, which was the percentage found by the German statutory health insurance.

In 2018, the direct cost alone of periodontal disease in the U.S. was $3.5 billion. In the same year periodontal disease directly cost Europeans 2.5 billion euros ($3.1 billion).

Indirect costs, meanwhile, were $150.6 billion in the U.S. and $197.1 billion in Europe. The majority of indirect costs were due to edentulism related to periodontal disease and root caries, the authors noted. Germany, France, and the U.K. experienced the highest productivity losses due to periodontal diseases.

The costs of periodontal disease are part of larger healthcare and dental spending in both regions. Residents spent a total of $3.5 trillion on health expenditures in the U.S. versus 1.7 trillion euros ($2.1 trillion) in Europe. The aggregate direct dental treatment costs alone were $101.3 billion in the U.S. and 73 billion euros ($89 billion) in Europe.

"These results present disturbing evidence about the undeniable impact that periodontal disease has on the economy," the authors wrote.

The study, however, had some shortcomings. A number of sources had insufficient information available, and national statistics often lack overall costs of periodontal treatments. The cost may also be underestimated because some therapies, such as surgical therapy, were not recorded as health statistics.

The authors argued more national data are needed to better understand direct costs of periodontal disease. This is especially important in the wake of the COVID-19 pandemic and the resulting economic downturn, which have led to worse oral and overall health.

"For this reason, we can conjecture that periodontal disease may grow even more with presumably higher economic impact," the authors wrote. "More than ever, it is fundamental to reinforce periodontal public health measures and articulate with national and continental entities."