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Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren
R Mariño1, J Fajardo, M Morgan
1Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, Victoria, Australia. rmarino@unimelb.edu.au
Community Dental Health
|March 16, 2013
Summary
Salt fluoridation is the most cost-effective dental caries prevention program for schoolchildren in Chile, saving society money. Most interventions are beneficial, though models may underestimate true benefits.
Area of Science:
- Public Health
- Dental Public Health
- Health Economics
Background:
- Dental caries remains a significant public health issue among schoolchildren.
- Effective and economically viable prevention strategies are crucial for resource allocation.
- Chile has implemented various community and school-based dental caries prevention programs.
Purpose of the Study:
- To estimate the cost-effectiveness of seven dental caries prevention programs in Chilean schoolchildren from a societal perspective.
- To compare community-based (water fluoridation, salt fluoridation, dental sealants) and school-based (milk fluoridation, fluoridated mouthrinses, APF-Gel, supervised toothbrushing) interventions.
- To identify the most economically efficient strategies for caries prevention.
Main Methods:
- A standard cost-effectiveness analysis was conducted over a 6-year period.
- Costs included program implementation, operation, and productivity losses.
- Health outcomes were measured as averted cases of dental caries (DMFT).
- Incremental cost-effectiveness ratios (ICERs) and sensitivity analyses were performed.
Main Results:
- Four programs demonstrated net social savings: salt fluoridation (US$16.21/tooth averted), community water fluoridation (US$14.89/tooth averted), milk fluoridation (US$14.78/tooth averted), and fluoridated mouthrinses (US$8.63/tooth averted).
- APF-Gel (US$21.30/tooth averted), dental sealants (US$11.56/tooth averted), and supervised toothbrushing (US$8.55/tooth averted) incurred societal costs per tooth averted.
- Salt fluoridation emerged as the most cost-effective intervention.
Conclusions:
- Salt fluoridation is the most cost-effective dental caries prevention strategy for schoolchildren in Chile.
- Most evaluated community and school-based interventions represent efficient use of societal resources.
- The study's conservative models likely underestimate the full benefits of these dental caries prevention programs.
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