The cost-effectiveness of supportive periodontal care: a global perspective

Abstract

Pennington M, Heasman P, Gaunt F, Güntsch A, Ivanovski S, Imazato S, Rajapakse S, Allen E, Flemmig T, Sanz M, Vernazza C. The cost‐effectiveness of supportive periodontal care: a global perspective. J Clin Periodontol 2011; doi: 10.1111/j.1600‐051X.2011.01722.x. Abstract Aim: To evaluate the cost‐effectiveness of supportive periodontal care (SPC) provided in generalist and periodontal specialist practices under publicly subsidized or private dental care. Material and methods: SPC cost data and the costs of replacing teeth were synthesized with estimates of the effectiveness of SPC in preventing attachment and tooth loss and adjusted for differences in clinician's time. Incremental cost‐effectiveness ratios were calculated for both outcomes assuming a time horizon of 30 years. Results: SPC in specialist periodontal practice provides improved outcomes but at higher costs than SPC provided by publicly subsidized or private systems. SPC in specialist periodontal practice is usually more cost‐effective than in private dental practice. For private dental practices in Spain, United Kingdom and Australia, specialist SPC is cost‐effective at modest values of attachment loss averted. Variation in the threshold arises primarily from clinician's time. Conclusion: SPC in specialist periodontal practice represents good value for money for patients (publicly subsidized or private) in the United Kingdom and Australia and in Spain if they place relatively modest values on avoiding attachment loss. For patients in Ireland, Germany, Japan and the United State, a higher valuation on avoiding attachment loss is needed to justify SPC in private or specialist practices.

Cost analysis of Periodontitis management in public sector specialist dental clinics

“…Indirect cost as measured by patients’ loss of productivity while seeking dental treatment was low, amounting to only 4% of the total cost, including provider cost. In the periodontal literature, patient costs reported usually include expenses paid for the dental treatment received as well as traveling time and no additional component [15,17,34]. Expenses spent for traveling to and from the dental clinic is infrequently measured [35].…”

“…Another is on the cost-effectiveness of supportive periodontal care between specialist and generalist periodontal practice [17]. These studies however, had estimated costs based on recommended charges, third-party reimbursements or national expenditures.…”

Cost‐effectiveness of non‐surgical periodontal therapy for patients with type 2 diabetes in the UK

“…Procedure times for tooth extraction, provision of removable dentures and resin‐bonded bridges were taken from Pennington et al. (). Laboratory costs for prosthetic replacements were also included.…”

“…We assumed the following prosthetic replacements for lost teeth based on data reported by Pennington et al. (): 45% resin‐bonded bridge, 40% removable partial denture, 15% no replacement (gap). This generated a mean cost for tooth loss of £295 in total, and £181 net of patient co‐payments.…”

Cost‐effectiveness of regularversusirregular supportive periodontal therapy or tooth removal

“…Discounting accounts for opportunities forgone if spending money now instead of later, or gaining health benefits later instead of now (Pennington et al. ).…”