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Modeling the cost-effectiveness of school-based supervised toothbrushing program in reducing the dental caries burden
Shweta Sharda1, Arpit Gupta2, Gaurav Jyani1
1Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Background:
Supervised toothbrushing (STB) significantly reduces the incidence and progression of dental caries. School years present a favorable age for introducing such healthy habits for a lifetime.
Aim:
To estimate the cost-effectiveness of implementing a STB program in India in preventing dental caries incidence.
Design:
An operational framework of a national STB program was devised. A mathematical model was then developed to evaluate this program's clinical effectiveness and economic impact in the Indian scenario. This study considered a hypothetical cohort of the Indian population aged from 6 to 75 years. Two groups were compared: no intervention and STB in government schools. The health outcomes assessed were a number of tooth caries incidences averted and quality-adjusted life years gained.
Results:
The STB program in the government schools of India would prevent at least one tooth from developing caries in an individual's lifetime. Considering the current treatment-seeking behavior, the STB program saves INR 153 (US$ 1.95) per carious tooth incidence averted and INR 22 202 (US$ 283) per QALY gained.
Conclusion:
In India, the school-based STB program is expected to be a cost-effective strategy for reducing the dental caries burden and its associated treatment costs.
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