Economic appraisal of preventive dental techniques

In this paper the principles and particular problems involved in applying economic appraisal to the evaluation of preventive dental care are investigated. There is no cost benefit analysis in the existing literature which gives a reliable indication of the relative efficiency of preventive and restorative dental techniques. This is because of difficulties involved in trying to attach monetary values to the benefits of programmes which are publicly provided. These difficulties are not resolved by representing the benefits of prevention by restorative costs averted. Although cost effectiveness analysis may seem a more straightforward method, it suffers from the inappropriateness of the dmft (or dmfs) statistic for measuring the relative effectiveness of restorative and preventive treatments. An alternative measure of dental health outcome is suggested which encompasses aspects of the quantity (in life years) and quality of teeth produced by restorative and preventive care. The full potential of economic appraisal of preventive dentistry will be realised only if such comprehensive measures of dental health outcome are produced. The task of producing such measures should involve dentists, consumers of dental care and health care researchers.