Ola Norrie1, Linda Pharand2. 1. Research associate, Evaluation Platform, George and Fay Yee Centre for Health Care Innovation, University of Manitoba & Winnipeg Regional Health Authority, Winnipeg, MB, Canada. 2. Senior dental hygienist, SMILEPlus Dental Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada.
Abstract
Objective: This project compares the cost effectiveness of a preventive fluoride varnish (FV) program with usual dental care (surgery under general anesthesia [GA]) for preschool children in 2 low-income communities in Winnipeg, Canada. Methods: Program impact is described in terms of cost, cavities avoided, and reductions in surgery volume. Aggregate data for 873 children ages 1 to 6 years old enrolled in the Winnipeg Regional Health Authority Daycare Fluoride Varnish Program in January 2018 were analysed using a Markov model. Results: The program was found to save approximately $822.98 per child over 5 years versus usual dental care. There were 4.38 cavities avoided per child and a savings of $187.71/cavity for the FV group. Participants' need for dental surgery under GA was reduced from 19.1% in the usual care group to 1.6% in the FV group (92% reduction) over 5 years. Sensitivity analyses using a Monte Carlo simulation showed that the program was cost effective over usual care 100% of the time. Finally, it was estimated that the program had saved $753,000 since its inception, or approximately $41.15 per FV application. Conclusion: The FV intervention had better health outcomes, lower costs, and was less invasive than usual care involving dental surgery under GA for children enrolled in the program.
Objective: This project compares the cost effectiveness of a preventive fluoride varnish (FV) program with usual dental care (surgery under general anesthesia [GA]) for preschool children in 2 low-income communities in Winnipeg, Canada. Methods: Program impact is described in terms of cost, cavities avoided, and reductions in surgery volume. Aggregate data for 873 children ages 1 to 6 years old enrolled in the Winnipeg Regional Health Authority Daycare Fluoride Varnish Program in January 2018 were analysed using a Markov model. Results: The program was found to save approximately $822.98 per child over 5 years versus usual dental care. There were 4.38 cavities avoided per child and a savings of $187.71/cavity for the FV group. Participants' need for dental surgery under GA was reduced from 19.1% in the usual care group to 1.6% in the FV group (92% reduction) over 5 years. Sensitivity analyses using a Monte Carlo simulation showed that the program was cost effective over usual care 100% of the time. Finally, it was estimated that the program had saved $753,000 since its inception, or approximately $41.15 per FV application. Conclusion: The FV intervention had better health outcomes, lower costs, and was less invasive than usual care involving dental surgery under GA for children enrolled in the program.
Authors: Robert J Weyant; Sharon L Tracy; Theresa Tracy Anselmo; Eugenio D Beltrán-Aguilar; Kevin J Donly; William A Frese; Philippe P Hujoel; Timothy Iafolla; William Kohn; Jayanth Kumar; Steven M Levy; Norman Tinanoff; J Timothy Wright; Domenick Zero; Krishna Aravamudhan; Julie Frantsve-Hawley; Daniel M Meyer Journal: J Am Dent Assoc Date: 2013-11 Impact factor: 3.634
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