{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:01:00Z","timestamp":1781244060217,"version":"3.54.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aims to estimate the annual NHS treatment cost associated with projected dental caries and periodontal disease burden in the UK adult population from 2020 to 2050.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prevalence-based cost-of-illness projection was built from population-level estimates of dental caries, periodontal pocketing and loss of attachment from a previously published multi-state population projection model. Bottom-up costing from an NHS perspective used the Units of Dental Activity contract framework with attendance rates derived from the adult oral health survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total annual NHS costs are projected to rise from \u00a34,418\u202fm in 2020 (95% CI \u00a34,388\u2013\u00a34,449\u202fm) to \u00a35,301\u202fm in 2050 (\u00a35,204\u2013\u00a35,398\u202fm), a 20% increase. The 60+ age group will bear 69% of caries-related costs by 2050, up from 45% in 2020. Untreated caries costs in those aged 60\u202f+\u202fwill grow by 168%, and severe periodontal pocketing costs by 57%. Per capita cost rises from \u00a380.76 to \u00a390.84.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NHS dental expenditure will be increasingly concentrated among older adults with severe disease. These findings provide an economic rationale for focusing NHS dental commissioning towards older adult oral health and earlier-life prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1863227","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:48:54Z","timestamp":1781243334000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the direct healthcare costs of oral diseases in the United Kingdom: a cost-of-illness projection to 2050"],"prefix":"10.3389","volume":"14","author":[{"given":"Edward","family":"Coote","sequence":"first","affiliation":[{"name":"21D Clinical Limited","place":["Warrington, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitesh","family":"Patel","sequence":"additional","affiliation":[{"name":"21D Clinical Limited","place":["Warrington, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Vijayanarayanan","sequence":"additional","affiliation":[{"name":"21D Clinical Limited","place":["Warrington, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1627746","DOI":"10.3389\/froh.2025.1627746","article-title":"Global, regional, and national burden of periodontal diseases from 1990 to 2021 and predictions to 2040: an analysis of the global burden of disease study 2021","volume":"6","author":"Hu","year":"2025","journal-title":"Front Oral Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1190197","DOI":"10.3389\/fpubh.2023.1190197","article-title":"Projecting the burden of dental caries and periodontal diseases among the adult population in the United Kingdom using a multi-state population model","volume":"11","author":"Elamin","year":"2023","journal-title":"Front Public Health"},{"key":"ref3","volume-title":"Adult Oral Health Survey 2023: A Report on the Findings of the 2023 Adult Oral Health Survey","year":"2025"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1002\/JPER.18-0157","article-title":"A new classification scheme for periodontal and peri-implant diseases and conditions \u2013 introduction and key changes from the 1999 classification","volume":"89","author":"Caton","year":"2018","journal-title":"J Periodontol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1111\/jper.10813","article-title":"Economic burden of periodontitis in the United States and Europe: an updated estimation","volume":"93","author":"Botelho","year":"2022","journal-title":"J Periodontol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1177\/0022034517750572","article-title":"Global-, regional-, and country-level economic impacts of dental diseases in 2015","volume":"97","author":"Righolt","year":"2018","journal-title":"J Dent Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1093\/ehjqcco\/qcaf011","article-title":"Economic burden of cardiovascular disease in the United Kingdom","volume":"11","author":"Shih","year":"2025","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"653","DOI":"10.2165\/11588380-000000000-00000","article-title":"Cost-of-illness studies: a guide to critical evaluation","volume":"29","author":"Larg","year":"2011","journal-title":"PharmacoEconomics"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: a global public health challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet"},{"key":"ref10","volume-title":"Funding NHS Dentistry: What NHS Finance Professionals need to Know","year":"2025"},{"key":"ref11","volume-title":"How Am I Awarded for a Course of Treatment (CoT) in England?","year":"2022"},{"key":"ref12","volume-title":"Units of Dental Activity (UDA) Changes to Band 2 Treatments from Friday 25 November","year":"2022"},{"key":"ref13","volume-title":"NHS England Annual Report and Accounts 2024 to 2025","year":"2025"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e009476","DOI":"10.1136\/bmjopen-2015-009476","article-title":"Burden of poor oral health in older age: findings from a population-based study of older British men","volume":"5","author":"Ramsay","year":"2015","journal-title":"BMJ Open"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.jdent.2016.11.002","article-title":"The relationship between oral health and oral health related quality of life among elderly people in United Kingdom","volume":"56","author":"Masood","year":"2017","journal-title":"J Dent"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41415-024-7740-x","article-title":"Barriers and facilitators to accessing oral healthcare for older people in the UK: a scoping review","volume":"16","author":"Beaven","year":"2024","journal-title":"Br Dent J"},{"key":"ref17","volume-title":"Commissioning Better Oral Health for Vulnerable Older People","year":"2018"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1038\/s41405-024-00262-z","article-title":"Healthy ageing and oral health: priority, policy and public health","volume":"10","author":"Patel","year":"2024","journal-title":"BDJ Open"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0140-6736(08)61933-9","article-title":"Oral health: prevention is key","volume":"373","year":"2009","journal-title":"Lancet"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1186\/s12903-023-03030-x","article-title":"Barriers to prevention in oral health care for English NHS dental patients: a qualitative study of views from key stakeholders","volume":"23","author":"Leggett","year":"2023","journal-title":"BMC Oral Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e0316702","DOI":"10.1371\/journal.pone.0316702","article-title":"Effectiveness of oral health promotion in children and adolescents through behaviour change interventions: a scoping review","volume":"20","author":"Peerbhay","year":"2025","journal-title":"PLoS One"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12877-023-04613-7","article-title":"Oral health and healthy ageing: a scoping review","volume":"24","author":"Poudel","year":"2024","journal-title":"BMC Geriatr"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e521","DOI":"10.1016\/S2666-7568(21)00142-2","article-title":"Oral health for healthy ageing","volume":"2","author":"Patel","year":"2021","journal-title":"Lancet Healthy Longev"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e514","DOI":"10.1016\/S2666-7568(24)00108-9","article-title":"The economic burden of cancer, coronary heart disease, dementia, and stroke in England in 2018, with projection to 2050: an evaluation of two cohort studies","volume":"5","author":"Landeiro","year":"2024","journal-title":"Lancet Healthy Longev"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e15326","DOI":"10.1111\/dme.15326","article-title":"Estimation of the direct health and indirect societal costs of diabetes in the UK using a cost of illness model","volume":"41","author":"Hex","year":"2024","journal-title":"Diabet Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"iii73","DOI":"10.1093\/ndt\/gfs269","article-title":"Estimating the financial cost of chronic kidney disease to the NHS in England","volume":"27","author":"Kerr","year":"2012","journal-title":"Nephrol Dial Transplant"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1038\/s41415-022-3987-2","article-title":"Unlocking the potential of NHS primary care dental datasets","volume":"232","author":"Moore","year":"2022","journal-title":"Br Dent J"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1863227\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:48:56Z","timestamp":1781243336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1863227\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":27,"alternative-id":["10.3389\/fpubh.2026.1863227"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1863227","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"article-number":"1863227"}}