{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T16:29:04Z","timestamp":1773073744815,"version":"3.50.1"},"posted":{"date-parts":[[2021,1,20]]},"group-title":"Health Economics","reference-count":29,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2021,1,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Periodontal disease is a pandemic condition and its severe form affects approximately 10% of the global population. Here, we present a forecast for the economic burden of periodontal disease in 32 European countries and in the United States of America (USA).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Material and methods<\/jats:title>\n                  <jats:p>In an aggregate population-based cost analysis, taken as reference the most recent available data, we estimated the cost of periodontal disease. Under this, global health, dental and periodontal expenditures were estimated. Additionally, indirect estimates accounted for Disability-Adjusted Life Years (DALY) valued at per capita Gross Domestic Product (GDP), to estimate productivity losses, including periodontal disease, edentulism due to periodontal disease and caries due to 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 Europe was estimated at \u20ac17.00B and \u20ac2.35B more in the USA (\u20ac19.35B). Indirect costs due to periodontal disease amounted to \u20ac132.52B in European countries and \u20ac103.30B in the USA. The majority of the projected indirect costs were due to edentulism related to periodontal disease and periodontal disease. Indirect costs were the major portion of the estimated economic impact with an average of 0.66% of GDP in Europe and 0.50% in the USA. For the overall costs (direct and indirect), the value amounted to 0.75% of GDP in Europe and 0.60% in the USA.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Periodontal disease caused a \u20ac149.52B loss in Europe and \u20ac122.65B in the USA, in 2018. These results show that the economic burden of periodontal disease is increasing.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>CLINICAL RELEVANCE<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Scientific rationale for the study<\/jats:title>\n                    <jats:p>Considering the pandemic pattern of periodontal diseases we present a forecast for the economic burden of periodontal disease in 32 European countries and in the United States of America (USA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal findings<\/jats:title>\n                    <jats:p>Periodontal disease caused a \u20ac149.52B loss in Europe and \u20ac122.65B in the USA, in 2018. For the overall costs (direct and indirect), the value amounted to 0.75% of GDP in Europe and 0.60% in the USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practical implications<\/jats:title>\n                    <jats:p>These results show that the economic burden of periodontal disease is increasing.<\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.1101\/2021.01.19.21250090","type":"posted-content","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T15:30:12Z","timestamp":1611156612000},"source":"Crossref","is-referenced-by-count":6,"title":["Economic Burden of Periodontal Disease in Europe and the United States of America \u2013 An updated forecast"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-8263","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Botelho","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-5936","authenticated-orcid":false,"given":"Lu\u00eds","family":"Proen\u00e7a","sequence":"additional","affiliation":[]},{"given":"Yago","family":"Leira","sequence":"additional","affiliation":[]},{"given":"Leandro","family":"Chambrone","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0167-4077","authenticated-orcid":false,"given":"Jos\u00e9 Jo\u00e3o","family":"Mendes","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-260X","authenticated-orcid":false,"given":"Vanessa","family":"Machado","sequence":"additional","affiliation":[]}],"member":"54368","reference":[{"issue":"8","key":"2021012209001727000_2021.01.19.21250090v1.1","doi-asserted-by":"crossref","first-page":"e362","DOI":"10.1016\/S2352-3026(16)30062-X","article-title":"Economic burden of malignant blood disorders across Europe: a population-based cost analysis","volume":"3","year":"2016","journal-title":"The Lancet Haematology"},{"key":"2021012209001727000_2021.01.19.21250090v1.2","doi-asserted-by":"crossref","unstructured":"Caton, J. G. , Armitage, G. , Berglundh, T. , Chapple, I. L. C. , Jepsen, S. , Kornman, K. S. , Mealey, B. L. , Papapanou, P. N. , Sanz, M. , & Tonetti, M. S. (2018). A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. Journal of Periodontology, 89(March), S1\u2013S8. https:\/\/doi.org\/10.1002\/JPER.18-0157","DOI":"10.1002\/JPER.18-0157"},{"key":"2021012209001727000_2021.01.19.21250090v1.3","unstructured":"EFP. (2021). What is periodontitis? https:\/\/www.efp.org\/what-is-periodontitis\/"},{"issue":"1","key":"2021012209001727000_2021.01.19.21250090v1.4","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/prd.12323","article-title":"Recent epidemiologic trends in periodontitis in the USA","volume":"82","year":"2020","journal-title":"Periodontology 2000"},{"issue":"7","key":"2021012209001727000_2021.01.19.21250090v1.5","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.adaj.2018.04.023","article-title":"Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014","volume":"149","year":"2018","journal-title":"Journal of the American Dental Association"},{"issue":"1","key":"2021012209001727000_2021.01.19.21250090v1.6","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/prd.12145","article-title":"Periodontitis prevalence in adults \u2265 65 years of age, in the USA","volume":"72","year":"2016","journal-title":"Periodontology 2000"},{"key":"2021012209001727000_2021.01.19.21250090v1.7","unstructured":"European Commission. Eurostat: Your key to European Statistics. (n.d.). Retrieved January 9, 2021, from https:\/\/ec.europa.eu\/eurostat\/data\/database"},{"key":"2021012209001727000_2021.01.19.21250090v1.8","doi-asserted-by":"crossref","unstructured":"GBD. (n.d.). IHME Data GBD Results Tool. Retrieved January 11, 2021, from http:\/\/ghdx.healthdata.org\/gbd-results-tool","DOI":"10.1093\/med\/9780190082543.003.0002"},{"key":"2021012209001727000_2021.01.19.21250090v1.9","doi-asserted-by":"publisher","DOI":"10.1038\/nri3785"},{"key":"2021012209001727000_2021.01.19.21250090v1.10","unstructured":"ILOSTAT. (2021). ILOSTAT. https:\/\/ilostat.ilo.org\/"},{"key":"2021012209001727000_2021.01.19.21250090v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7."},{"key":"2021012209001727000_2021.01.19.21250090v1.12","doi-asserted-by":"publisher","DOI":"10.1177\/0022034514552491"},{"key":"2021012209001727000_2021.01.19.21250090v1.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.10.024"},{"key":"2021012209001727000_2021.01.19.21250090v1.14","doi-asserted-by":"publisher","DOI":"10.1177\/0022034515602879"},{"issue":"8","key":"2021012209001727000_2021.01.19.21250090v1.15","doi-asserted-by":"crossref","first-page":"e371","DOI":"10.1016\/S2352-3026(16)30061-8","article-title":"Economic burden of non-malignant blood disorders across Europe: a population-based cost study","volume":"3","year":"2016","journal-title":"The Lancet Haematology"},{"key":"2021012209001727000_2021.01.19.21250090v1.16","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70442-X"},{"issue":"1","key":"2021012209001727000_2021.01.19.21250090v1.17","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1177\/2396987319883160","article-title":"Economic burden of stroke across Europe: A population-based cost analysis","volume":"5","year":"2020","journal-title":"European Stroke Journal"},{"key":"2021012209001727000_2021.01.19.21250090v1.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2010.01620.x"},{"key":"2021012209001727000_2021.01.19.21250090v1.19","unstructured":"NSS. (2019). Dental Statistics \u2013 NHS Treatment and Fees (Issue September). OECD. (2021). https:\/\/data.oecd.org\/."},{"issue":"4","key":"2021012209001727000_2021.01.19.21250090v1.20","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j.1600-051X.1996.tb00550.x","article-title":"Periodontal reasons for tooth loss in an Asian population","volume":"23","year":"1996","journal-title":"Journal of Clinical Periodontology"},{"key":"2021012209001727000_2021.01.19.21250090v1.21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1875-595X.1998.tb00711.x"},{"key":"2021012209001727000_2021.01.19.21250090v1.22","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051X.1999.260105.x"},{"issue":"3","key":"2021012209001727000_2021.01.19.21250090v1.23","doi-asserted-by":"crossref","first-page":"424","DOI":"10.2105\/AJPH.57.3.424","article-title":"Estimating the cost of illness","volume":"57","year":"1967","journal-title":"American Journal of Public Health and the Nation\u2019 s Health"},{"key":"2021012209001727000_2021.01.19.21250090v1.24","doi-asserted-by":"crossref","unstructured":"Righolt, A. J. , Jevdjevic, M. , Marcenes, W. , & Listl, S. (2018). Global-, Regional-, and Country-Leve Economic Impacts of Dental Diseases in 2015. Journal of Dental Research. https:\/\/doi.org\/10.1177\/0022034517750572","DOI":"10.1177\/0022034517750572"},{"issue":"3","key":"2021012209001727000_2021.01.19.21250090v1.25","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/jcpe.13189","article-title":"Periodontitis and cardiovascular diseases: Consensus report","volume":"47","year":"2020","journal-title":"Journal of Clinical Periodontology"},{"key":"2021012209001727000_2021.01.19.21250090v1.26","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12732"},{"key":"2021012209001727000_2021.01.19.21250090v1.27","unstructured":"U. S. Department of Health and Human Services Healthy People 2020. (2010). https:\/\/www.healthypeople.gov\/2020\/topics-objectives\/topic\/oral-health\/objectives"},{"key":"2021012209001727000_2021.01.19.21250090v1.28","unstructured":"WHO. (2001). Health financing. http:\/\/www.who.int\/macrohealth\/en\/"},{"key":"2021012209001727000_2021.01.19.21250090v1.29","unstructured":"WHO. (2021). WHO Global Health Expenditure Database. https:\/\/apps.who.int\/nha\/database"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2021.01.19.21250090","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T14:03:49Z","timestamp":1768485829000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2021.01.19.21250090"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,20]]},"references-count":29,"URL":"https:\/\/doi.org\/10.1101\/2021.01.19.21250090","relation":{"is-preprint-of":[{"id-type":"doi","id":"10.1002\/jper.21-0111","asserted-by":"subject"}]},"subject":[],"published":{"date-parts":[[2021,1,20]]},"subtype":"preprint"}}