Preventive and non-invasive treatment for dental caries appears to be cost-effective

shutterstock_68251921 dental education young girl and nurses

The aim of this study was to assess the efficacy and cost-effectiveness of a non-invasive approach to dental caries management in private dental practice.

The Caries Management System is a 10-step non-invasive strategy to arrest and remineralize early lesions. The main principle is that caries management must include consideration of the patient at risk, the status of each lesion, patient management, clinical management and monitoring. Both dental caries risk and treatment are managed according to a set of protocols that are applied at various steps throughout patient consultation and treatment.

This was a cluster randomised controlled trial within private dental practices from a variety of locations in New South Wales. Patients were followed for three years and caries incidence assessed. A patient-level decision analytic model was constructed to assess the cost-effectiveness of the intervention at two years, three years, and hypothetical lifetime. Twenty-two dental practices and 920 patients were recruited.

They found:

  • A significant difference in caries increment favouring non-invasive therapy at both two and three years.
  • Efficacy was independent of age, gender, medical concerns, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices, in a variety of locations both urban and rural.
  • Cost per DMFT avoided estimate was A$1287.07 (two years), A$1148.91 (three years) decreasing to A$702.52 in (medium) and A$545.93 (high) risk patients (three years).

They concluded:

A joint preventive and non-invasive therapeutic approach appears to be cost-effective in patients at medium and high risk of developing dental caries when compared to the standard care provided by private dental practice.

Curtis B, Warren E, Pollicino C, Evans RW, Schwarz E, Sbaraini A. The Monitor Practice Programme: is non-invasive management of dental caries in private practice cost-effective? Aust Dent J. 2011 Mar;56(1):48-55. doi: 10.1111/j.1834-7819.2010.01286.x. Epub 2011 Jan 10. PubMed PMID: 21332740

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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