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


  • Conflict of interest and source of funding statement
    The study has no specific source of funding nor was it supported by a grant award. None of the authors or their institutions have any conflict of interests.

P.A. Heasman
School of Dental Sciences
Newcastle University
Framlington Place
Newcastle upon Tyne


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.


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.