Cost-effectiveness of caries preventive interventions – a systematic review

Davidson, Thomas; Blomma, Caroline; Bågesund, Mats; Krevers, Barbro; Vall, Martina; Gerdin, Elisabeth Wärnberg; Tranæus, Sofia

doi:10.1080/00016357.2020.1862293

Cited by 13 publications

(22 citation statements)

References 48 publications

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“…Evidence for the cost-effectiveness of interventions is also an important consideration to assist decision makers in determining investment decisions. In the past 10 years, seven systematic reviews of economic evaluations were focused on preventive interventions for dental caries and/or periodontitis [23][24][25][26][27][28][29]. Six systematic reviews were exclusively focused on dental caries, of which four reviews were on child populations [25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

“…When considering the focus of these reviews, five reviews were primarily concerned with investigating the quality of the economic evaluation studies [23][24][25][26]29]. Four reviews provided an overall economic evaluation quality score using various checklists [23,25,27,29], although determining study quality using a scoring system is not a best practice recommendation [30,31].…”

Section: Introductionmentioning

confidence: 99%

“…The most common preventive interventions that have been economically evaluated include water fluoridation [23,29], fissure sealant applications [23,26,29], and the use of topical fluorides such as fluoride varnish applications and fluoride mouth rinses [24,26,28]. Only three out of the six systematic reviews that assessed these preventive interventions reported whether the preventive interventions were cost-effective [24][25][26]. This is due, in part, to the reviews' primary aim being to determine the quality of economic evaluation studies.…”

Section: Introductionmentioning

confidence: 99%

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Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

Nguyen

Tonmukayakul

et al. 2022

Appl Health Econ Health Policy

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Objectives To critically examine the methods used for full economic evaluations of preventive interventions for dental caries and periodontitis. Methods Published literature post-2000 was searched to April 2021. Based on a developed intervention classification framework for dental caries and periodontitis, only universal, selective or indicated interventions were included in this review. The Drummond 10-point checklist was used for quality appraisal. Results Of 3,007 unique records screened for relevance, 73 studies were reviewed. Most model-based studies (61/73) used cost-effectiveness analysis (49%) or cost-benefit analysis (28%). Trial-based studies (16/73) commonly used cost-effectiveness analysis (59%). Four studies used both economic evaluation methods. Sixty-four papers (88%) were on dental caries, eight papers (11%) focused on periodontitis, and one paper (1%) included both oral diseases; 72% of model-based and 82% of trial-based studies were of good quality. The most frequently investigated dental caries preventive interventions were water fluoridation (universal intervention; cost-saving or cost-effective), fissure sealant and fluoride varnish (selective and indicated interventions; cost-effectiveness outcomes were inconsistent). Supportive periodontal therapy with oral health education (indicated intervention; cost-effective) was the most frequently evaluated preventive intervention for periodontitis. Thirty percent of studies with a time horizon > 1 year did not apply an appropriate discount rate and 26% did not comprehensively discuss other important considerations beyond the technical analysis. Conclusions Generic health outcome measures should be incorporated for economic evaluations on preventive interventions for dental caries and periodontitis, and an increased focus to prevent periodontitis using economic evaluation methods is needed to inform resource allocation and policy decision-making.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

Nguyen

Tonmukayakul

et al. 2022

Appl Health Econ Health Policy

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show abstract

“…Furthermore, it is of importance to identify the best value for money, which means that limited resources should be used in the most effective way to obtain the largest health-care gain. A recent systematic review found several cost-effectiveness evaluations of caries preventive interventions in the literature, but these target primarily children at high risk [ 11 ]. There is a paucity of cost-effectiveness studies of general caries-preventive programs.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, there are some earlier prevention studies on school-based fluoride rinsing that show a remaining effect on caries prevalence and incidence after cessation of the rinsing programs, but at that time, there were no evaluations of costs [ 14 , 15 , 16 ]. Furthermore, several studies have analyzed the cost-effectiveness of long-term fluoride varnish [ 17 , 18 , 19 ] but with inconclusive results [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Cost-Effectiveness through the Dental-Health FRAMM Guideline for Caries Prevention

Davidson

Bergström

Husberg

et al. 2022

IJERPH

Self Cite

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A guideline called FRAMM, which is an acronym in Swedish for the most important parts of this guideline, namely “fluoride”, “advice”, “arena”, “motivation” and “diet”, was implemented in 2008 in the Västra Götaland Region in Sweden. This guideline included fluoride varnish applications performed at school twice a year at six-monthly intervals for all 12- to 15-year-olds, together with lessons on oral health. The aim of this analysis was to estimate the long-term cost-effectiveness, using prognostic calculations, of the FRAMM Guideline for 12- to 15-year-olds, compared with routine care, until the participants were 23 years old. A cost-effectiveness analysis was performed from a health care perspective, based on four years of verified data and seven years of prognosis. Data from FRAMM were combined with cost data from price lists in Sweden. The cost-effectiveness was analyzed by relating the difference in costs to the difference in the number of approximal surfaces with fillings and/or dentin lesions (DFSa). The analysis shows that FRAMM was considered dominant compared to the controls in all alternative scenarios, hence costs were prognosed to be lowered and outcomes were prognosed to be improved. A dental health program like the FRAMM Guideline with fluoride varnish during the caries risk period from 12 to 15 years is predicted to be cost-effective in the longer perspective. To further study the actual long-term caries increment after a preventive dental health program would be of great interest to verify these results.

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Evaporation strategy generated antibacterial enamel-like fluorapatite-polyacrylic acid sheet for functional dental restoration

Zhang

Wong

2022

Composites Part B: Engineering

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Cost-effectiveness of caries preventive interventions – a systematic review

Cited by 13 publications

References 48 publications

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

Long-Term Cost-Effectiveness through the Dental-Health FRAMM Guideline for Caries Prevention

Evaporation strategy generated antibacterial enamel-like fluorapatite-polyacrylic acid sheet for functional dental restoration

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