The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis

J Clin Periodontol. 2008 Sep;35(8 Suppl):67-82. doi: 10.1111/j.1600-051X.2008.01261.x.


Objective: To systematically evaluate the evidence for effectiveness of supportive periodontal care (SPC) provided in specialist care and general practice for patients with chronic periodontitis; to construct a model for the cost effectiveness of SPC.

Search strategy: Electronic database searches of MEDLINE, EMBASE and SCOPUS were performed with hand searching of relevant journals and Workshops of Periodontology.

Selection criteria: SPC for patients with chronic periodontitis, at least 12 months follow-up and clinical attachment level as a primary outcome.

Results: Three articles addressed the question (Nyman et al. 1975, Axelsson & Lindhe 1981, Cortellini et al. 1994): Deltas CAL for patients undergoing "specialist" SPC were 0.1 mm (2 years), 0.2 mm (6 years) and -0.01 mm (3 years) respectively. In generalist care the Deltas CAL during SPC were -2.2, -1.8 and -2.8 mm. Differences between specialist and generalist SPC were an extra 20.59 tooth years and 3.95 mm attachment loss for generalist SPC. Incremental cost-effectiveness ratios were an extra 288 euros for one tooth year or an extra 1503 euros/1 mm reduction in loss of attachment for SPC delivered in specialist care.

Conclusion: SPC delivered in specialist as compared with general practice will result in greater stability of clinical attachment but this will be achieved at relatively greater cost.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chronic Periodontitis / economics
  • Chronic Periodontitis / prevention & control*
  • Cost-Benefit Analysis
  • Dental Hygienists / economics
  • Dental Scaling / economics
  • Disease Progression
  • General Practice, Dental / economics
  • Health Care Costs
  • Humans
  • Periodontics / economics
  • Recurrence
  • Root Planing / economics
  • Treatment Outcome