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Despite this burden, periodontal care remains weakly integrated into global NCD strategies, limiting public health advocacy and healthy aging. We conducted a conceptual and policy\u2010oriented analysis to identify opportunities for repositioning periodontal care as a public health function. Key domains examined included (a) preventive healthcare through the common risk factor approach; (b) case identification and diagnosis designed to serve both clinical care and population surveillance; (c) de\u2010implementation of care with limited incremental benefit at scale, including the role of payment incentives in shaping utilization. To evaluate long\u2010term affordability, projected global periodontal healthcare expenditure through 2050 was modeled using a cohort\u2010based Monte Carlo simulation, comparing current utilization patterns, expansion to 80% population coverage, and an alternative capitation\u2010informed scenario. Reorienting periodontal care toward proactive, cost\u2010effective prevention and integrating case identification within primary care and NCD platforms offer greater potential for equitable population health gains than simply expanding procedure\u2010intensive treatments. Risk\u2010stratified care pathways based on patient\u2010important outcomes, combined with de\u2010implementation of low\u2010value practices, can preserve oral function while reducing avoidable service volume and costs. Expenditure modeling indicates that achieving high coverage under prevailing fee\u2010for\u2010service delivery would substantially increase global financial burden, whereas a capitation\u2010informed scenario reduced projected expenditure by 30% at the same coverage level, suggesting alternative incentives could expand access with less cost escalation, including in low\u2010 and middle\u2010income settings worldwide. Aligning periodontal care with public health principles\u2014prioritizing prevention, value, and equity over treatment volume\u2014is a paradigm shift essential for achieving sustainable improvements in population health, healthy aging, and long\u2010term health\u2010system affordability.<\/jats:p>","DOI":"10.1111\/jre.70133","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:36:57Z","timestamp":1781797017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Periodontal Diseases as a Public Health Challenge: Rationale, Prevention, Equity, and Sustainable Care\u2014A Global Call for Action"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8329-2808","authenticated-orcid":false,"given":"Marco A.","family":"Peres","sequence":"first","affiliation":[{"name":"National Dental Research Institute Singapore National Dental Centre Singapore  Singapore Singapore"},{"name":"Health Services and Population Health Research Programme Duke\u2010NUS Medical School  Singapore Singapore"},{"name":"Oral Health Academic Clinical Program Duke\u2010NUS Medical School Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-9710","authenticated-orcid":false,"given":"Lijian","family":"Jin","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo G.","family":"Nascimento","sequence":"additional","affiliation":[{"name":"School of Dentistry University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7153-4865","authenticated-orcid":false,"given":"Philip M.","family":"Preshaw","sequence":"additional","affiliation":[{"name":"School of Dental Sciences Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero Juhani","family":"Raittio","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Health Aarhus University  Aarhus Denmark"},{"name":"Institute of Dentistry University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1664-9979","authenticated-orcid":false,"given":"Dian Yi","family":"Chow","sequence":"additional","affiliation":[{"name":"National Dental Research Institute Singapore National Dental Centre Singapore  Singapore Singapore"},{"name":"Department of Restorative Dentistry National Dental Centre Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3042-3103","authenticated-orcid":false,"given":"John Rong Hao","family":"Tay","sequence":"additional","affiliation":[{"name":"National Dental Research Institute Singapore National Dental Centre Singapore  Singapore Singapore"},{"name":"Health Services and Population Health Research Programme Duke\u2010NUS Medical School  Singapore Singapore"},{"name":"Department of Restorative Dentistry National Dental Centre Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02811-3"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jre.13337"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.r1070"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(22)00315-2"},{"key":"e_1_2_11_6_1","unstructured":"World Health Organization \u201cGlobal Strategy and Action Plan on Oral Health 2023\u20132030 \u201d Geneva 2024."},{"key":"e_1_2_11_7_1","unstructured":"World Health Organization \u201cBangkok Declaration: No Health Without Oral Health \u201d Geneva 2024."},{"key":"e_1_2_11_8_1","unstructured":"World Health Organization \u201cHLM4: on the Road to 2025 and Beyond. 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