A detailed framework of methods used to calculate costs of periodontal treatment in Malaysian public dental clinics

To address research gaps arising from scarcity of documented costing methods in dentistry, this paper provides detailed framework of combined methods used to estimate costs of periodontal procedures. Five specialist periodontal clinics in the Ministry of Health, Malaysia provided clinical and cost data for this study. An expert panel group identified thirty clinical procedures and classified them as diagnostics, non-surgical periodontal treatment and periodontal surgeries. We acquired cost data, administrative and financial records for year 2012 from these clinics, national annual reports, as well as observation of 60 patients undergoing various periodontal treatments to ascertain personnel, time, equipment and materials consumed. We combined two costing methods in this study: the step-down and activity-based costing (ABC) methods, which were substantiated by a clinical pathway. We measured costs using 2012 Malaysian Ringgit (MYR) values. A total examination package cost MYR121, but separate diagnostics procedures such as full-mouth periodontal assessment, electric pulp test, intraoral/ panoramic radiographs averaged MYR75. Full-mouth supragingival scaling cost MYR215 and full-mouth subgingival debridement MYR638, higher if with systemic/local delivery antibiotics. Cost of regenerative surgeries (MYR1899) was two-fold the resective surgeries (MYR904). Providers spent about 41% on consumables and the rest on dental equipment (25%), salary (24%) and administration (9%). This study shares the detailed methodology for dental costing which is important as basis for undertaking cost of illness study and estimating economic burden of any oral disease. Cost of periodontal procedures varies according to type of procedure, equipment and consumables used as well as time taken to perform the procedures