Gum disease may cost more than patients' teeth

Though largely preventable, periodontal disease poses significant economic and societal burdens, emphasizing a need for policy interventions, according to a review article recently published in Periodontology 2000.

To reduce the impact of periodontitis, it is important to integrate general health and oral health systems, implement policies addressing social inequalities, and target common risk factors, according to the study.

"There is a strong need for further awareness raising and professionalizing health economic research in periodontology," wrote the authors, led by Madhuri Pattamatta of the Radboud University Medical Center in the Netherlands (Periodontol 2000, May 14, 2024).

Periodontitis can lead to tooth loss and is associated with other systemic health conditions, but it can also directly and indirectly affect patients' wallets.

Worldwide, treatment expenses or direct costs were estimated at $298 billion in 2010, about $357 billion in 2015, and $387 billion in 2019. A significant portion of these expenditures is attributable to periodontitis.

Based on the global burden of dental disease and that about 36% of tooth loss is due to periodontitis, it is estimated that 48% of the global burden of dental disease is attributable to this chronic gum disease, resulting in direct costs of $186 billion for severe periodontitis, according to the study.

Globally, indirect costs of periodontitis, which are primarily due to productivity losses from missing work or school, were estimated at $82 billion in 2019. If edentulism and caries resulting from periodontitis are considered, these losses may be higher, bringing the total productivity costs to $142 billion.

In the U.S., the indirect costs due to periodontitis were estimated at approximatley $151 billion, and in Europe, the indirect costs approach about $156 billion, with most costs related to edentulism, they wrote.

To prevent and control periodontitis, upstream policy interventions targeting oral health inequalities and shared risk factors with other noncommunicable diseases are recommended. This should include focusing on social determinants of health and promoting equity through public health approaches, the authors wrote.

Additionally, there's a call for greater attention to health economic research in periodontology, including considerations such as provider payment, insurance coverage, and human resource planning alongside using generic health outcome measures to enhance comparability in evaluations across healthcare domains, they wrote.

However, there was a gap in evidence regarding the cost-effectiveness of public health and preventive interventions for periodontitis, highlighting the need for further research, they added.

"In conclusion, periodontal diseases are a major global public health problem with a high prevalence and economic burden worldwide," Pattamatta et al wrote.