Australian program reduces dental costs, caries

Jun 22, 2010

An Australian caries management system was found to be most cost-effective in patients with a high risk of dental caries, according to a study in Value in Health (June 17, 2010), the official journal of the International Society for Pharmacoeconomics and Outcomes Research.

The three-year randomized clinical trial, conducted by researchers from the University of Sydney and Hera Consulting Australia, evaluated the long-term efficacy and cost-effectiveness of a preventive approach used in the general practice setting and modeled to the Australian population.

Using a patient-simulation Markov model to compare the long-term costs and outcomes of the Caries Management System versus standard dental care in a hypothetical sample representative of the Australian population, they calculated the incremental cost per DMFT (decayed, missing, and filled teeth) avoided at two years, three years, and lifetime and found the incremental cost per DMFT avoided to be $1,287.07, $1,148.91, and $1,795.06, respectively.

"The Monitor Practice Program demonstrated that regular monitoring and noninvasive management of dental caries is effective in reducing the incremental DMFT in patients," the researchers wrote.

In addition, the program was effective in reducing the incidence of new and recurrent decay over the three-year study period by more than 40%. These results were independent of age, gender, medical status, fluoride history, or previous history of dental caries. Further, in patients categorized at medium to high risk of developing dental decay, it appears the program was reasonably cost-effective when compared to existing dental care practice.

"This newly adopted system for early decay diagnosis has opened opportunities for action to prevent cavities," said study co-author Wendell Evans in a press release. "The shift in resources toward more expensive and cosmetic procedures, while understandable, is creating a resource and access issue that will require the collaboration of the profession, patients, dental funds, and researchers. We see this study very much as a first step toward defining and potentially addressing the problem."