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[Efficacy and cost analysis of two fluoride varnishes in community-based interventions for early childhood caries]
Chaoqing Yang1,2, Jinmei Yu1, Yishan Zhang1
1College & Hospital of Stomatology, Guangxi Medical University, Guangxi Key Laboratory of the Rehabilitation and Reconstruction for Oral and Maxillofacial Research, Guangxi Clinical Research Center for Craniofacial Deformity, Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning 530021, China.
Objectives:
A community intervention mo-del was used to investigate the preventive effects and cost-effectiveness of I-ReHealth® and Duraphat® in early childhood caries.
Methods:
Children from Yizhou District, Hechi City, were enrolled and randomly assigned into two groups: the I-ReHealth® group and the Duraphat® group. Each group received topical fluoride varnish applications and dental health education every 6 months. After 1.5 years, the incidence of caries and associated costs were compared between the two groups before and after the intervention. Cost minimization analysis was employed to evaluate economic efficiency, and sensitivity analysis was performed to assess the influence of variations in key parameters on result stability and to quantify the probabilistic differences in cost benefits between the two fluoride varnishes under equivalent caries-preventive effects.
Results:
Prior to the intervention, we found no statistically significant differences in caries prevalence or mean dmft scores between the two groups (P>0.05). After 1.5 years of treatment, both groups still showed no statistically significant differences in caries prevalence (P>0.05), mean dmft scores (P>0.05), caries incidence rate (P>0.05), or increment in mean dmft (P>0.05). The one-sided 97.5% confidence interval for the difference in mean dmft increment was below the non-inferiority threshold, confirming non-inferiority (P<0.025). Cost minimization analysis revealed lower total costs in the I-ReHealth® group (¥25 411.44) than in the Duraphat® group (¥26 692.98). One-way sensitivity analysis identified material price as the most influential parameter affecting total costs. Monte Carlo simulation with 1 000 iterations demonstrated a 73.1% probability that the I-ReHealth® group will yield cost savings compared with the Duraphat® group.
Conclusions:
I-ReHealth® is non-inferior to Duraphat® in caries-preventive efficacy but superior in cost-effectiveness in reducing patient expenses.
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