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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;e2025035. Published online July 3, 2025
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DOI: https://doi.org/10.4178/epih.e2025035
[Accepted]
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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 $13.79 to $10.47 million. Indirect costs, comprising transportation and time costs, ranged from $0.89 to $0.80 million. Total costs declined from $14.68 to $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
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Incidence of edentulism among older adults using the Korean National Health Insurance Service database, 2013-2018
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Hyeonjeong Go, Eun-Kyong Kim, Hoi-In Jung, Song Vogue Ahn, Hosung Shin, Atsuo Amano, Youn-Hee Choi
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Epidemiol Health. 2022;44:e2022091. Published online October 17, 2022
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DOI: https://doi.org/10.4178/epih.e2022091
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Abstract
PDF
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Abstract
OBJECTIVES
Population aging is rapidly accelerating worldwide. Oral diseases related to aging are also on the rise. This study examined trends in the incidence of edentulism among the older Korean population using data from the Korean National Health Insurance Service (KNHIS).
METHODS Data on older adults, aged ≥75 years of age, were obtained from the KNHIS for the period 2013-2018. Edentulism was defined as a treatment history of complete dentures in the KNHIS database. The exclusion criteria consisted of both disease codes and treatment codes related to conservative dental treatment, including periodontal and extraction treatment afterward. Crude incidence rates (CIRs) and age-standardized incidence rates (AIRs) with 95% confidence intervals were calculated and reported per 100,000 person-years by the direct method. Trends were tested by Cochrane Armitage models.
RESULTS Statistically significant increasing trends in both CIRs and AIRs were found among the older Korean population registered in the KNHIS (CIRs, 707.92 to 895.92; AIRs, 705.11 to 889.68; p<0.01). The incidence tended to increase in both genders (p<0.01). Both CIRs and AIRs in specific regions also showed slight but significant annual increases except for Jeju Island (p<0.01 or <0.05). The incidence showed increasing trends (p<0.01) in all income quintiles apart from the highest quintile. The edentulism incidence was highest in the lowest income group (the first quintile).
CONCLUSIONS Our data showed that the incidence of edentulism among the elderly showed an increasing trend from 2013 to 2018. This result provides a basis for future epidemiological studies on the incidence of edentulism in the older Korean population.
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Summary
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Citations
Citations to this article as recorded by  - Evaluation of lateral and axial forces in atrophic maxilla with angled pterygoid implant using three dimensional finite element analysis
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Advances in Oral and Maxillofacial Surgery.2025; 18: 100545. CrossRef - Trend in the Incidence of Severe Partial Edentulism among Adults Using the Korean National Health Insurance Service Claim Data, 2014–2018
Hyeonjeong Go, Hoi-In Jung, Song Vogue Ahn, Jeonghoon Ahn, Hosung Shin, Atsuo Amano, Youn-Hee Choi
Yonsei Medical Journal.2024; 65(4): 234. CrossRef - Decomposition Analysis of the Prevalence of Denture Use Between Rural and Urban Older Individuals With Edentulism in China: Cross-Sectional Study
Lei Yuan, Yuan Yuan, Haotian Ren, Feng Zhang, Zhe Zhao, Qinqin Jiang, Zhenbang Wei, Jin-hai Sun
Interactive Journal of Medical Research.2024; 13: e48778. CrossRef - Estimated economic costs of dental implants among older South Korean adults, 2015–2018
Hyeonjeong Go, Jeonghoon Ahn, Song Vogue Ahn, Hosung Shin, Atsuo Amano, Youn‐Hee Choi
Clinical Oral Implants Research.2024; 35(12): 1560. CrossRef
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