Risk-based caries prevention may be more effective in children.

DESIGN: Randomised control trial in six-year-old children. INTERVENTION: The control group received dental check-ups twice a year, including professional fluoride gel applications and fissure sealants. The increased professional fluoride application (IPFA) group has the same care as in the control group plus two additional fluoride gel application per year. The non-operative caries treatment and prevention (NOCTP) had individualised recall intervals following the Nexø protocol.(1) Data on time and resource use as well as data on effectiveness were collected for three years. OUTCOME MEASURE: The primary outcome measure was the incremental cost effectiveness ratio of methods of caries prevention. Other outcomes included societal and health perspective cost effectiveness of the caries prevention methods and overall effectiveness (number of prevented DMFS) of the methods.
RESULTS: Two hundred and thirty children participated in the trial, with a 32% drop out in the NOCTP group, 20% in the IPFA group and 15% in the control group. The resources use and total costs in Euros over three years are shown in the table below.
CONCLUSIONS: The NOCTP regimen was more effective and more costly than regular dental care. Based on the limited available amount of evidence regarding the willingness to pay for dental care, the benefits seem to outweigh the additional costs, implying that this is a cost-effective strategy. Increasing the number of professional fluoride applications resulted in a slight reduction of caries increment, but at higher costs than the NOCTP strategy. The results of this study confirm the findings in previous research. Therefore, implementing NOCTP on a larger scale should be considered.

RCT Entities:   Population Interventions Outcomes