In June 2021, The Economist Intelligence Unit reported evidence showing improvement in periodontal health leads to better overall health outcomes, with societal and economic implications accounted for (1). This economic return-on-investment (ROI) model for prevention and management of periodontitis was done in six Western European countries; France, Germany, Italy, the Netherlands, Spain, and the United Kingdom.
Five modeled scenarios were used, ranging from current curative treatment concepts, elimination of gingivitis via improved home care, to unmanaged periodontitis in a do-nothing scenario. In all countries, elimination of gingivitis via improved home care provided the highest ROI. The second highest ROI was diagnosis and management of periodontitis in 90% of the population.
The concept of prevention is not new. Health is best when prevention is prioritized. In Malaysia, the well-established preschool and school incremental dental programmes have tackled caries prevention to some degree. However, the scenario differs for gum health. According to the National Oral Health Survey of School children 2017, 99.8% of 12-year-old students presented with gingival bleeding on probing. Similar findings were reported in the National Oral Health Survey of Adults 2010 (2).
Often, gum bleeding is perceived as normal, and not many choose to seek treatment. Currently, the general public’s awareness of tooth loss associated with risk factors is still poor. Even among primary healthcare workers, there is much to be desired in their attitude towards the importance of gum health (3). Although government provided dental treatment is cheap, and private dental care aplenty and frequently utilized, our approach to gum health still remains curative. Not many are aware of different hygiene aids available, healthy diets associated with health, nor risk factors that cause gingivitis and subsequently periodontitis(4).
All is not bleak. Recent efforts have been made to push gum health a priority; periodontitis is included in the recent Ministry of Health clinical practice guidelines of management of type 2 diabetic mellitus, and social media is often used as a promotional tool for gum health. Despite this, bigger players are required to make a substantive impact on this public health issue.
We need the public and private working hand in hand to empower people with the knowledge and tools to optimize their own gum health. Professionals in both fields need to emphasize on prevention, spending time to disseminate information that will allow individuals to improve gum health at home. It is effective in both cost and in health rewards.
Successful stories of gum health, whether prevention, or management of gingivitis or periodontitis, only happen when the patient takes charge of his or her own wellbeing. It is time to let the patient take charge, and take gum disease seriously in Malaysia.
- The Economist Intelligence Unit Limited (2021). Time to take gum disease seriously. The societal and economic impact of periodontitis.
- National Oral Health Survey for adults 2010: Key findings,Paper Presented at NOHSA 2010. Seminar 7-10th November, Ministry of Health Malaysia 2012.
- Nordin NN, Vaithilingam RD, Saub R, et al. Awareness, knowledge, attitudes and practices on the management of diabetes mellitus patients with periodontitis amongst Malaysian primary care practitioners. Malays Fam Physician. 2021;16(3):44-55. Published 2021 Sep 22. doi:10.51866/oa1131
- England N, Improvement N. Commissioning Standard: Dental Care for People with Diabetes. England: NHS England and NHS Improvement. 2019;17(11).