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Data for this observational retrospective study were collected from dental charts of patients who had received periodontal therapy and at least annual follow\u2010up visits for &gt;10\u2009years were analyzed by linear regression generalized estimating equations and generalized linear models. Among 399 adults (199 males, 200 females), those with the least mean annual treatment cost experienced the greatest mean annual costs for extraction\/replacement, indicating general cost\u2010effectiveness. Cigarette smoking adversely impacted this cost\u2010effectiveness, with current heavy smokers experiencing no cost\u2010effectiveness. Former smokers with Grade C periodontitis benefitted most, whereas smoking did not influence cost\u2010effectiveness for Grade B periodontitis. Assessed by mean annual costs of \u201cextraction\/replacement,\u201d periodontal treatment was cost\u2010effective, which decreased in a dose\u2013response manner by former and current smoking intensity. Cigarette smoking should be factored into treatment planning and cost\u2010effective analyses of periodontal treatment. Smoking cessation should be encouraged.<\/jats:p>","DOI":"10.1111\/prd.12585","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T01:20:37Z","timestamp":1721956837000},"page":"32-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of smoking on cost\u2010effectiveness of 10\u201348\u2009years of periodontal care"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3029-8130","authenticated-orcid":false,"given":"Andrea","family":"Ravid\u00e0","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine The University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Department of Periodontics and Preventive Dentistry University of Pittsburgh School of Dental Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5067-7317","authenticated-orcid":false,"given":"Muhammad H. 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