BACKGROUND: The objective of this research was to assess the efficacy and cost-effectiveness of a non-invasive approach to dental caries management in private dental practice. METHODS:Private dental practices from a variety of locations in New South Wales were randomly allocated to either non-invasive management of caries, or continue with usual care. 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. RESULTS:Twenty-two dental practices and 920 patients were recruited. Within the clinical trial there was 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). CONCLUSIONS: 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.
RCT Entities:
BACKGROUND: The objective of this research was to assess the efficacy and cost-effectiveness of a non-invasive approach to dental caries management in private dental practice. METHODS: Private dental practices from a variety of locations in New South Wales were randomly allocated to either non-invasive management of caries, or continue with usual care. 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. RESULTS: Twenty-two dental practices and 920 patients were recruited. Within the clinical trial there was 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). CONCLUSIONS: 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.
Authors: John P Brown; Bennett T Amaechi; James D Bader; Daniel Shugars; William M Vollmer; Chuhe Chen; Gregg H Gilbert; Elisabeth J Esterberg Journal: Community Dent Oral Epidemiol Date: 2015-02-05 Impact factor: 3.383
Authors: Stefania Martignon; Andrea Cortes; Gail V A Douglas; J Timothy Newton; Nigel B Pitts; Viviana Avila; Margarita Usuga-Vacca; Luis F Gamboa; Christopher Deery; Ninoska Abreu-Placeres; Clarisa Bonifacio; Mariana M Braga; Fabiana Carletto-Körber; Patricia Castro; María P Cerezo; Nathaly Chavarría; Olga L Cifuentes; Beatriz Echeverri; Sofía Jácome-Liévano; Irina Kuzmina; J Sebastián Lara; David Manton; E Angeles Martínez-Mier; Paulo Melo; Michèle Muller-Bolla; Emilia Ochoa; Jesús R Osorio; Ketty Ramos; Angie F Sanabria; Johanna Sanjuán; Magdalena San-Martín; Aldo Squassi; A Karina Velasco; Rita Villena; Andrea Ferreira Zandona; Edgar O Beltrán Journal: BMC Oral Health Date: 2021-07-01 Impact factor: 2.757
Authors: Margaret Pukallus; Kathryn Plonka; Sanjeewa Kularatna; Louisa Gordon; Adrian G Barnett; Laurence Walsh; W Kim Seow Journal: BMJ Open Date: 2013-05-14 Impact factor: 2.692