Estimating the direct healthcare costs of oral diseases in the United Kingdom: a cost-of-illness projection to 2050

Aims: This study aims to estimate the annual NHS treatment cost associated with projected dental caries and periodontal disease burden in the UK adult population from 2020 to 2050. Methods: A prevalence-based cost-of-illness projection was built from population-level estimates of dental caries, periodontal pocketing and loss of attachment from a previously published multi-state population projection model. Bottom-up costing from an NHS perspective used the Units of Dental Activity contract framework with attendance rates derived from the adult oral health survey. Results: Total annual NHS costs are projected to rise from £4,418 m in 2020 (95% CI £4,388-£4,449 m) to £5,301 m in 2050 (£5,204-£5,398 m), a 20% increase. The 60+ age group will bear 69% of caries-related costs by 2050, up from 45% in 2020. Untreated caries costs in those aged 60 + will grow by 168%, and severe periodontal pocketing costs by 57%. Per capita cost rises from £80.76 to £90.84. Conclusion: NHS dental expenditure will be increasingly concentrated among older adults with severe disease. These findings provide an economic rationale for focusing NHS dental commissioning towards older adult oral health and earlier-life prevention.