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Occurrence rate and estimated economic burden of pulp and periapical disease treatment among Korean older adults: a national population-based retrospective study
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Hyeonjeong Go, Masae Kuboniwa, Youn-Hee Choi
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Epidemiol Health. 2025;47:e2025035. Published online July 3, 2025
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DOI: https://doi.org/10.4178/epih.e2025035
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 Abstract
Summary
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Abstract
OBJECTIVES
Maintaining healthy dentition is essential for the overall health of older adults. Treatment of pulp and periapical disease (PPD) is crucial for preserving teeth. This study assessed the occurrence rate and economic burden of PPD treatment in an older Korean population.
METHODS Data were obtained for adults aged ≥65 years from the Korean National Health Insurance Services from 2014 to 2018. The occurrence rate was defined as the proportion of individuals who received ≥1 PPD treatment. The economic burden was estimated using both direct and indirect expenditures, calculated from a societal perspective. Regression analysis was performed to evaluate yearly trends in occurrence rate and economic burden.
RESULTS Direct costs, which included insured and non-insured medical expenses, ranged from US$13.79 million to US$10.47 million. Indirect costs, comprising transportation and time costs, ranged from US$0.89 million to US$0.80 million. Total costs declined from US$14.68 million to US$11.36 million. The occurrence rate of PPD treatment decreased significantly from 1.24% to 0.91% (p<0.05). The economic burden also demonstrated a statistically significant downward trend, with total PPD costs decreasing from 0.00099% to 0.00066% of Korea’s GDP, and from 0.63% to 0.30% of the annual total dental care benefit costs between 2014 and 2018 (p<0.05).
CONCLUSIONS The occurrence rate and estimated economic burden of PPD treatment significantly decreased among older Korean adults from 2014 to 2018. Conservative approaches to tooth preservation contribute to more effective oral health policies and help reduce the economic burden of oral disease treatments in an aging society.
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Summary
Korean summary
· 한국 노년층에서 치수 및 치근단 질환 치료의 발생률과 경제적 부담은 연구 기간 동안 통계적으로 유의미하게 감소했습니다.
· 이러한 연구 결과는 보존적 치과 치료가 고령화 사회에서 구강 질환으로 인한 경제적 부담을 줄이는 효과적인 구강 보건 정책이 될 수 있음을 시사합니다.
Key Message
· The occurrence rate and economic burden of pulp and periapical disease (PPD) treatment among older Korean adults have shown a statistically significant decrease over the study period.
· These findings suggest that conservative dental treatment can serve as an effective oral health policy for reducing the economic burden of oral diseases in an aging society.
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