Time to take gum disease seriously: The societal and economic impact of periodontitis

A report commissioned by the EFP and published by the Economist Intelligence Unit (EIU), the research and analysis division of the Economist Group, provides a comprehensive analysis of the financial and human cost of gum disease in six Western European countries.

The report, "Time to take gum disease seriously: The societal and economic impact of periodontitis", was published on June 14 and explains how more effective prevention of gum disease could save billions in healthcare costs and lead to healthier lives. The six countries included in the study are France, Germany, Italy, the Netherlands, Spain, and the UK.

As the report makes clear, periodontitis is largely preventable with good oral hygiene and regular dental check-ups. However, it shows how in Western Europe little progress has been made in the prevention and management of periodontitis, with prevalence remaining largely unchanged over the last 25 years. One key factor highlighted by the report is that many people visit a dentist only when they have a problem and avoid regular appointments because of the cost.

It notes that in Spain and Italy, most if not all periodontitis treatment is paid for by patients or private insurance, so “periodontitis treatment for a low-income family is therefore rendered almost unaffordable”. Furthermore, while dental care appears to be “free on paper” in the UK and France, “only part of the dental procedures for treating periodontitis are covered and the remainder is paid for out-of-pocket.”

After providing evidence that professional management of periodontitis is cost-effective, the study argues that “publically covered dental care for periodontitis deserves a review from policy makers and commissioners Europe-wide”.

The EIU report, sponsored by Oral-B, part of the Procter & Gamble Company, makes four key recommendations: (1) The prevention, diagnosis, and management of periodontitis is cost-effective; (2) better integration of dental and general healthcare is required; (3) a synergy of societal and individual public-health campaigns is needed; (4) the affordability of dental care needs to be improved.

The study models the economic burden of periodontitis and the return on investment (ROI) of treatment, with separate modelling performed for France, Germany, Italy, the Netherlands, Spain, and the UK. The model was based on EFP treatment guidelines that outline four intervention points in the progression from (1) health to (2) gingivitis, (3) undiagnosed periodontitis, and (4) diagnosed periodontitis.

The modelling found that both eliminating gingivitis and increasing the rate of diagnosing and treating periodontitis to 90% had a positive ROI for all countries and gains in healthy life years compared to business as usual. Neglecting to manage gingivitis had the opposite effects.

The EFP’s current and former Secretary Generals, Professor Nicola West and Professor Iain Chapple, contributed to the report and the EIU also carried out interviews with 17 other leading periodontists. The economic modelling was performed by health economists at Triangulate Health.

“It is hugely challenging to determine the economic and societal costs of a complex disease like periodontitis, which is why we needed an independent expert group like the EIU to undertake this modelling,” said Iain Chapple, Professor of Periodontology at the University of Birmingham, former EFP Treasurer and Secretary General, and member of the EFP Workshop Committee. “Their data clearly demonstrates that by far the biggest ROI comes from the prevention of periodontitis – i.e., by treating gingivitis – something traditionally regarded as trivial and ignored – rather than with treatment being directed at periodontitis, which is of course too late for prevention.”

Professor Nicola West, Professor of Periodontology at Bristol University and EFP Secretary General, said: “I am delighted with the analysis presented by the EIU, highlighting the benefit to healthcare providers of treating gum disease early to realise gains in healthy life years, advancing the EFP’s purpose of promoting periodontal health for a better life.”

Read the full report HERE.

Explore the infographic showing the socioeconomic impact of periodontitis HERE.