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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
Hyeonjeong Go, Masae Kuboniwa, Youn-Hee Choi
Epidemiol Health. 2025;47:e2025035.   Published online July 3, 2025
DOI: https://doi.org/10.4178/epih.e2025035
  • 4,487 View
  • 59 Download
AbstractAbstract AbstractSummary PDF
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.
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.
Incidence of edentulism among older adults using the Korean National Health Insurance Service database, 2013-2018
Hyeonjeong Go, Eun-Kyong Kim, Hoi-In Jung, Song Vogue Ahn, Hosung Shin, Atsuo Amano, Youn-Hee Choi
Epidemiol Health. 2022;44:e2022091.   Published online October 17, 2022
DOI: https://doi.org/10.4178/epih.e2022091
  • 18,967 View
  • 280 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDF
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.
Summary

Citations

Citations to this article as recorded by  
  • Awareness, Attitudes, Needs, and Demands Toward Tooth Replacement Options Among Patients at an Emirati University‐Setting Clinic
    Amaweya Alsammarraie, K. Sulafa El-Samarrai, Kelvin I. Afrashtehfar, Musab Saeed, Esraa Jaber, Berksam Amr Fatouh, Shahenda A. L. Sayed, Sara Khoshniyat, Wala Alkurdi, Mawada Abdelmagied, Boonlert Kukiattrakoon
    International Journal of Dentistry.2026;[Epub]     CrossRef
  • Evaluation of lateral and axial forces in atrophic maxilla with angled pterygoid implant using three dimensional finite element analysis
    Thair Mahroq, Ahmet Arslan, İbrahim Mutlu, Zakaria Al Joulaji
    Advances in Oral and Maxillofacial Surgery.2025; 18: 100545.     CrossRef
  • Epidemiologic features and economic burden of Wilson’s disease in South Korea: a nationwide analysis of the entire patient population
    Dong Eun Im, Hye-Young Kang
    Scientific Reports.2025;[Epub]     CrossRef
  • Clinical Performance and Longevity of Implant-Assisted Removable Partial Dentures Compared to Other Removable Prosthesis Types: A Systematic Review
    Robert-Cosmin Dinu, Cristian-Laurentiu Comanescu, Sergiu Drafta, Alexandru-Eugen Petre
    Dentistry Journal.2025; 13(9): 389.     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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