The benefit of preventive procedures for high risk groups

Area of Science:

• Dental Public Health
• Health Economics
• Preventive Dentistry

Background:

• Clinical effectiveness of caries prophylactic agents is established, but their public health economic efficiency is often questioned.
• Certain population subgroups may exhibit enhanced responses to specific agents, potentially improving cost-value.
• Measuring agent effectiveness by reduction in operative treatment need is crucial for economic evaluation.

Purpose of the Study:

• To investigate the cost-effectiveness of caries prevention strategies compared to treatment alone.
• To analyze the economic efficiency of supervised daily brushing with MFP dentifrice and APF topical applications.
• To determine if specific high-risk groups benefit more from these interventions.

Main Methods:

• Costing operative treatment and prevention costs from clinical trial data.
• Utilizing a computer program to estimate treatment needs based on DMFS data.
• Applying the Resource Related Index for costing dental treatments.

Main Results:

• Supervised daily brushing with MFP dentifrice yielded a 25% DMFS reduction over three years, but cost 6.5 times the operative treatment saved.
• For a high-risk group of girls, the cost was only 2.5 times the operative treatment saved.
• Adding APF topical applications reduced economic efficiency further; neither program was cost-effective without valuing sound teeth over filled ones.

Conclusions:

• Caries prevention strategies like supervised brushing with MFP dentifrice may not be universally cost-effective for public health.
• Targeting high-risk groups can significantly improve the economic efficiency of preventive dental interventions.
• Valuing sound teeth over restored ones is essential for demonstrating the cost-effectiveness of certain preventive programs.