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

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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 a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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