Diagnostic and preventive services in a national incremental dental plan for children

A modelling exercise was carried out to examine the potential expenditure in a national incremental dental program for children aged six to 13. Using Relative Value Units (RVUs) as a proxy for dollars, the relative expenditures for care per child in fluoridated and fluoride-deficient areas were assessed. Dental treatment requirements were taken from existing data as far as possible. Arrangements for the delivery of care were based on existing pocicies of the American Dental Association, an services delivered were based on the recommendations of the American Academy of Pedodontics and the American Society of Dentistry for Children. Orthodontic care was limited to space maintainers and simple interceptive care. Children were assumed to receive initial care at age six, and annual maintenance care from ages seven to 13. The results showed that although restorative care would be 49.8 percent less expensive for children in fluoridated areas, total care would be only 11.9 percent less expensive. The major reason for this difference was the high proportion of annual maintenance-care costs that would be absorbed by diagnostic and preventive services using UCR fees. The necessity for much of this care is questioned under the conditions of this model, and some methods by which the dental profession might control the relatively high cost of diagnostic-preventive services are suggested.