Dental caries is a global public health concern affecting all age groups, especially children. In most cases, dental programs and oral health prevention programs rarely gain the level of attention that medical care receives. A recent systematic review published July 2019 in the International Journal of Environmental Research and Public Health aimed to “evaluate the clinical effectiveness and cost-effectiveness of oral-health promotion programs (OHPPs) aiming to improve children’s knowledge of favorable oral health behavior to lower decay/missing/filled teeth (DMFT) while reducing the financial cost on health institutions.”1
The economic burden of dental caries is a concern. Treatment for dental caries is a large portion of many countries’ healthcare budgets. In many diverse communities, OHPPs for children are implemented and have been shown to be useful in reducing the rate of dental caries. However, if it lessens the economic burden associated with dental caries is unclear. The authors of this systematic review hypothesize that “ exposure to oral health promotion programs reduce dental caries among children and health care costs.”
Several different models were evaluated for cost-effectiveness. In the UK an OHPP provided home visits with mothers of 8-month-old babies to provide counseling on preventing ECC. The average savings was $108,406.92. In another model, medical providers applied fluoride varnish at 9, 18, 24, and 36 months this model increased incremental cost by $10.93. The review included 19 studies total, these studies were timely diverse as they ranged between 1976 and 2018. The studies reported the use of OHPPs and the incremental costs within a year’s related cost.
This review determined that OHPPs can be clinically effective for children under the age of six, however, it is costly and needs fiscal management by health authorities. No significant higher clinical effectiveness was observed in children over the age of six yet would not be much costlier. A limitation mentioned by the authors was the diverse study timeframe which spanned seventy years. This showed that the economic evaluation fluctuated based on the year with which the program cost correlates. Additionally, it is important to consider the differential costs among different countries.
In multiple studies, the UK showed that OHPPs have a “significant effect in improving dental health status and reducing the cost of healthcare systems.” Other countries also report a significant effect, including Japan, Ireland, and Finland.
The authors conclude by stating, “More effort is needed to manage the allocation of scarce resources, taking into account the economic impact of dental caries on healthcare systems. Additionally, more studies are needed regarding caries-prevention methods among young age children in high-, middle- and low-income countries, with follow-up programs to analyze clinical and financial efficacy when conducting well-organized oral-health interventions.”
- Fraihat N, Madae’en S, Bencze Z, Herczeg A, Varga O. Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019 Jul 25;16(15):2668. doi: 10.3390/ijerph16152668. PMID: 31349691; PMCID: PMC6696287.