Cost-effectiveness considerations in planning a preventive dental programme for British Columbia.

Area of Science:

• Dental Public Health
• Preventive Dentistry
• Health Services Research

Background:

• In 1974, British Columbia initiated research for a comprehensive children's dental program.
• Existing dental care relied on fee-for-service private practitioners, operating near capacity.
• Government-sponsored educational and preventive programs existed, but child treatment utilization was only 60%.

Purpose of the Study:

• To evaluate cost-effectiveness of different dental caries prevention strategies for children.
• To identify optimal delivery systems for comprehensive pediatric dental care.
• To improve children's dental health utilization rates to at least 90%.

Main Methods:

• Costing of four potential dental care delivery systems.
• Review of effectiveness measurement techniques for anti-cariogenic measures.
• Comparison of eight topical fluoride systems (four professional, four self-administered) using a modified Davies cost-benefit ratio.

Main Results:

• The Knutson-Szwejda technique demonstrated the highest effectiveness in community dental health programs.
• Annual application of acidulated phosphate fluoride was deemed preferable for private practices and large pediatric clinics.
• School cooperation challenges were noted for mouth rinse programs, and "brush-in" program effectiveness lacked conclusive statistical proof.

Conclusions:

• The Knutson-Szwejda technique is highly effective for community-based pediatric dental caries prevention.
• Acidulated phosphate fluoride offers a viable alternative for private and clinic-based settings.
• Optimizing children's dental program delivery requires addressing logistical challenges and confirming program efficacy.