AbstractIntroductionPeriodontal disease is a pandemic condition and its severe form affects approximately 10% of the global population. Here, we present a forecast for the economic burden of periodontal disease in 32 European countries and in the United States of America (USA).Material and methodsIn an aggregate population-based cost analysis, taken as reference the most recent available data, we estimated the cost of periodontal disease. Under this, global health, dental and periodontal expenditures were estimated. Additionally, indirect estimates accounted for Disability-Adjusted Life Years (DALY) valued at per capita Gross Domestic Product (GDP), to estimate productivity losses, including periodontal disease, edentulism due to periodontal disease and caries due to periodontal disease.ResultsIn 2018 the aggregate cost in Europe was estimated at €17.00B and €2.35B more in the USA (€19.35B). Indirect costs due to periodontal disease amounted to €132.52B in European countries and €103.30B in the USA. The majority of the projected indirect costs were due to edentulism related to periodontal disease and periodontal disease. Indirect costs were the major portion of the estimated economic impact with an average of 0.66% of GDP in Europe and 0.50% in the USA. For the overall costs (direct and indirect), the value amounted to 0.75% of GDP in Europe and 0.60% in the USA.ConclusionPeriodontal disease caused a €149.52B loss in Europe and €122.65B in the USA, in 2018. These results show that the economic burden of periodontal disease is increasing.CLINICAL RELEVANCEScientific rationale for the studyConsidering the pandemic pattern of periodontal diseases we present a forecast for the economic burden of periodontal disease in 32 European countries and in the United States of America (USA).Principal findingsPeriodontal disease caused a €149.52B loss in Europe and €122.65B in the USA, in 2018. For the overall costs (direct and indirect), the value amounted to 0.75% of GDP in Europe and 0.60% in the USA.Practical implicationsThese results show that the economic burden of periodontal disease is increasing.