{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:45:01Z","timestamp":1778802301038,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100019370","name":"Foundation for Science and Technology","doi-asserted-by":"publisher","award":["UIDB\/04585\/2020"],"award-info":[{"award-number":["UIDB\/04585\/2020"]}],"id":[{"id":"10.13039\/501100019370","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["NIHR\u2010INF\u20100387"],"award-info":[{"award-number":["NIHR\u2010INF\u20100387"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study is to estimate the direct and indirect economic burdens of periodontal disease in the US and in Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the most recent data available for the US and for Europe (32 European countries) to estimate the cost of periodontal disease. Global health, dental and periodontal expenditures were estimated. We tried to estimate the direct and the indirect costs of periodontitis. Indirect costs, those related to productivity losses, are a consequence of periodontal disease proper, plus edentulism and caries because of periodontal disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2018, the aggregate cost in the US was estimated at $3.49B and \u20ac2.52B in Europe. Indirect costs because of periodontal disease amounted to $150.57B (95% confidence interval [CI]: 103.32\u2010189.87) in the US countries and \u20ac156.12B (95% CI: 123.72\u2010221.86) in Europe. The majority of the projected indirect costs were because of edentulism related to periodontal disease and periodontal disease. Indirect costs were the majority of the estimated economic impact with an average of 0.73% (95% CI: 0.50%\u20100.93%) of annual gross domestic product in the US and 0.99% (95% CI: 0.78%\u20101.40%) in Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Periodontal disease caused an estimated loss of $154.06B in the US and \u20ac158.64B in Europe, in 2018. These results show that the economic burden of periodontal disease is significant and its indirect costs are impactful.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.21-0111","type":"journal-article","created":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T19:49:46Z","timestamp":1622404186000},"page":"373-379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":162,"title":["Economic burden of periodontitis in the United States and Europe: An updated estimation"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-8263","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Botelho","sequence":"first","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM) Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"},{"name":"Evidenced\u2010Based Hub CiiEM, Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"}]},{"given":"Vanessa","family":"Machado","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM) Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"},{"name":"Evidenced\u2010Based Hub CiiEM, Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5027-7276","authenticated-orcid":false,"given":"Yago","family":"Leira","sequence":"additional","affiliation":[{"name":"Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre University College London  London UK"},{"name":"Periodontology Unit, Faculty of Medicine and Odontology University of Santiago de Compostela  Santiago de Compostela Spain"},{"name":"Medical\u2010Surgical Dentistry (OMEQUI) Research Group Health Research Institute of Santiago de Compostela (IDIS)  Santiago de Compostela Spain"},{"name":"Clinical Neurosciences Research Laboratory Health Research Institute of Santiago de Compostela (IDIS)  Santiago de Compostela Spain"}]},{"given":"Lu\u00eds","family":"Proen\u00e7a","sequence":"additional","affiliation":[{"name":"Evidenced\u2010Based Hub CiiEM, Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"},{"name":"Quantitative Methods for Health Research (MQIS) CiiEM, Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-1015","authenticated-orcid":false,"given":"Leandro","family":"Chambrone","sequence":"additional","affiliation":[{"name":"Evidenced\u2010Based Hub CiiEM, Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"},{"name":"Graduate Dentistry Program, School of Dentistry Ibirapuera University  S\u00e3o Paulo Brazil"},{"name":"Unit of Basic Oral Investigation (UIBO) Universidad El Bosque  Bogota Colombia"}]},{"given":"Jos\u00e9 Jo\u00e3o","family":"Mendes","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM) Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"},{"name":"Evidenced\u2010Based Hub CiiEM, Egas Moniz \u2013 Cooperativa de Ensino Superior  Almada Portugal"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12732"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034514552491"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri3785"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.57.3.424"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034515602879"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034517750572"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2010.01620.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987319883160"},{"key":"e_1_2_7_11_1","unstructured":"World Health Organization.WHO Global Health Expenditure Database. 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