Cost-effectiveness of school-based caries screening using transillumination

Area of Science:

• Dental Public Health
• Health Economics
• Diagnostic Technologies

Background:

• School-based caries screening typically relies on visual-tactile methods.
• Early detection of proximal caries is crucial for timely intervention.
• Near-infrared light transillumination (NILT) offers potential for improved caries detection.

Purpose of the Study:

• To assess the cost-effectiveness of NILT for school-based caries screening in Germany.
• To compare NILT with the standard visual-tactile screening method.
• To evaluate health outcomes in terms of tooth retention and costs.

Main Methods:

• A German mixed-payers' perspective was adopted.
• A Markov model simulated patient outcomes over a lifetime.
• Monte-Carlo microsimulations and sensitivity analyses were performed.

Main Results:

• NILT was minimally more effective (56 years tooth retention) and less costly (515 Euro) than standard care (56 years; 526 Euro).
• The incremental cost-effectiveness ratio (ICER) was -503 Euro/year, indicating cost savings with NILT.
• Cost-effectiveness improved with higher willingness-to-pay thresholds, driven by avoided tooth replacements.

Conclusions:

• NILT-based screening shows limited effectiveness gains and cost savings in the German model.
• Cost-effectiveness is likely higher in countries with less frequent dental screening or higher caries prevalence.
• NILT-based caries screening is unlikely to be cost-effective in German schools under current patterns.