Theoretical considerations in applying benefit-cost and cost-effectiveness analyses to preventive dental programs

Area of Science:

• Public Health
• Health Economics
• Dental Public Health

Background:

• Benefit-cost analysis (BCA) and cost-effectiveness analysis (CEA) are crucial for evaluating health interventions.
• These economic tools aid policymakers in making informed resource allocation decisions for public health programs.
• Preventive dental programs require rigorous evaluation to maximize public health benefits.

Purpose of the Study:

• To apply BCA and CEA to evaluate four distinct preventive dental programs.
• To compare the economic efficiency and net benefits of various dental caries prevention strategies.
• To inform policy decisions regarding resource allocation for dental public health initiatives.

Main Methods:

• Defined and described BCA and CEA methodologies.
• Calculated benefit-cost ratios (B/C) and cost-effectiveness ratios (C/E) for four programs: community water fluoridation, school water fluoridation, school mouthrinses, and school sealants.
• Analyzed programs under steady-state conditions and over a 20-year period, including explicit and implicit costs.

Main Results:

• Community water fluoridation demonstrated the highest net benefits and most favorable B/C and C/E ratios.
• School water fluoridation and mouthrinsing programs exhibited similar cost-effectiveness, particularly when teacher time costs were excluded.
• School-based sealant programs resulted in negative net benefits, indicating lower economic efficiency.

Conclusions:

• Community water fluoridation is the most economically advantageous preventive dental strategy.
• School-based water fluoridation and mouthrinsing programs offer significant cost-effectiveness for caries prevention.
• The economic evaluation highlights the importance of selecting high-yield interventions for public dental health, with sealants showing less favorable outcomes.