title: The lifetime direct cost of periodontal treatment: a case study from a Norwegian specialist practice.
abstract: BACKGROUND
  Successful periodontal treatment requires a commitment to regular lifelong maintenance and may be perceived by patients to be costly. This study calculates the total lifetime cost of periodontal treatment in the setting of a specialist periodontal practice and investigates the cost implications of choosing not to proceed with such treatment.
  
  
  METHODS
  Data from patients treated in a specialist practice in Norway were used to calculate the total lifetime cost of periodontal treatment that included baseline periodontal treatment, regular maintenance, retreatment, and replacing teeth lost during maintenance. Incremental costs for alternative strategies based on opting to forego periodontal treatment or maintenance and to replace any teeth lost with either bridgework or implants were calculated.
  
  
  RESULTS
  Patients who completed baseline periodontal treatment but did not have any additional maintenance or retreatment could replace only three teeth with bridgework or two teeth with implants before the cost of replacing additional teeth would exceed the cost of lifetime periodontal treatment. Patients who did not have any periodontal treatment could replace ≤ 4 teeth with bridgework or implants before a replacement strategy became more expensive.
  
  
  CONCLUSIONS
  Within the limits of the assumptions made, periodontal treatment in a Norwegian specialist periodontal practice is cost-effective when compared to an approach that relies on opting to replace teeth lost as a result of progressive periodontitis with fixed restorations. In particular, patients who have initial comprehensive periodontal treatment but do not subsequently comply with maintenance could, on average, replace ≤ 3 teeth with bridgework or two teeth with implants before this approach would exceed the direct cost of lifetime periodontal treatment in the setting of the specialist practice studied.
authors.affiliation: fardal@odont.uio.no
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Fardal
authors.forename: Ciaran
authors.initials: C
authors.lastname: O'Neill
authors.forename: Per
authors.initials: P
authors.lastname: Gjermo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fardal
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: B Frode
authors.initials: BF
authors.lastname: Hansen
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Linden
mesh_terms: D055113:Chronic Periodontitis / Q000191:economics* / Q000628:therapy; D003362:Cost-Benefit Analysis; D015921:Dental Implants / Q000191:economics*; D003830:Denture, Partial, Fixed / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D009664:Norway; D019982:Organizational Case Studies; D010517:Periodontics / Q000191:economics*; D019057:Quality-Adjusted Life Years; D016388:Tooth Loss / Q000191:economics
chemical_list: D015921:Dental Implants