THE CARIES MANAGEMENT SYSTEM: UPDATING COST-EFFECTIVENESS WITH 4-YEAR POSTTRIAL DATA

Area of Science:

• Dental Public Health
• Health Economics
• Clinical Dentistry

Background:

• Dental caries remains a significant public health concern, necessitating effective management strategies.
• The Caries Management System (CMS) offers a protocol for monitoring and noninvasive caries management.
• Previous economic evaluations indicated the potential cost-effectiveness of the CMS.

Purpose of the Study:

• To re-evaluate the per-protocol cost-effectiveness of the Caries Management System (CMS).
• To assess the long-term effectiveness of CMS in reducing caries-related events over a 7-year period.
• To analyze CMS cost-effectiveness in a real-life setting using 4-year posttrial follow-up data.

Main Methods:

• Utilized a previously developed individual patient-simulation Markov model based on 3-year RCT data.
• Simulated dental caries incidence, progression, and interventions.
• Re-evaluated long-term cost-effectiveness from the Australian private dental practitioner perspective using posttrial follow-up data.

Main Results:

• A sustained reduction in caries risk was observed in practices adhering to CMS protocols.
• The per-protocol model accurately predicted restorative event risk during the follow-up period.
• The lifetime cost per avoided restorative event was AUD1,980 (USD1,409).

Conclusions:

• The Caries Management System (CMS) is effective in reducing dental caries when protocols are appropriately followed.
• CMS demonstrates cost-effectiveness compared to standard dental care in Australian private practices.
• Long-term adherence to CMS protocols supports sustained caries risk reduction and economic benefits.