Adding smoking to the Fardal model of cost-effectiveness for the lifetime treatment of periodontal diseases

J Periodontol. 2018 Nov;89(11):1283-1289. doi: 10.1002/JPER.17-0467. Epub 2018 Aug 29.

Abstract

Background: Little is known about the financial costs that smoking adds to the lifetime treatment of periodontal disease.

Methods: The total lifetime cost of periodontal treatment was modeled using data from private periodontal practice. The costs of initial and supportive therapy, re-treatment and tooth replacements (with bridgework or implants) were identified using average dental charges from the American Dental Association survey. Smoking costs at $6 and $10 for 20 cigarettes were compared to the costs of lifetime periodontal treatment for stable and unstable compliant patients.

Results: Smoking added 8.8% to the financial cost of the lifetime cost of periodontal therapy in stable maintenance patients, 40.1% in patients who needed one extra maintenance visit, and 71.4% in patients who needed two extra maintenance visits per year in addition to added retreatment. The cost of smoking far exceeded the cost of periodontal treatment; For patients who smoked 10 to 40 cigarettes per day at the cost of $6 or $10 a pack, the cost of smoking exceeded the cost of lifetime periodontal treatment by between 2.7 and 17.9 times. Smoking 40 cigarettes at $10 a packet for 3.4 years would pay for the entire lifetime cost of periodontal treatment.

Conclusion: Smoking adds considerable extra financial costs to the lifetime treatment of periodontal diseases. The cost of smoking itself exceeds the cost of periodontal therapy.

Keywords: cigarette smoking; cost effectiveness; periodontal disease; treatment costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Dental Care
  • Humans
  • Periodontal Diseases*
  • Smoking
  • Tooth Loss*