Is non-invasive management of dental caries in private practice cost-effective? A randomized controlled trial [ 2006 - 2008 ]

Research Grant

Researchers: A/Pr Wendell Evans (Principal investigator) ,  Ms Adrienne Kirby ,  Ms Christine Pollicino ,  Prof Eli Schwarz

Brief description Despite evidence to the contrary, dentists routinely fill decayed teeth that, managed preventively, would be likely to repair (arrest). The probable cost to society of this approach is enormous. Modeling indicates that each new dental filling is likely to cost an average of $1811 (US) over the life-cycle of a tooth. This figure includes re-treatment costs, and the increased likelihood of more expensive re-treatment in future, such as root canal treatment and tooth crowning. An examination of the societal costs involved is likely to reveal this amount to be an under-estimate; consider the costs borne by sectors outside health: days lost to work, lost productivity. Further, we should consider costs to families: travel time and costs, childcare, the opportunity cost of items forgone in order to pay for the dental treatment. Despite this, a recent systematic review of dental caries prevention concluded 'there is presently no proof, in published economic evaluations of the cost-effectiveness of caries-preventive measures'. The authors highlighted a lack of methodologically sound studies. This research will compare a targeted preventive program to standard care within private dental practices. Prior to an alternative approach being introduced, an assessment of effectiveness and cost-effectiveness is needed. It is through such assessment that the value of the comparator can be assessed and our precious health dollars saved. The radical surgical approach (filling) that evolved to deal with the caries problem is entrenched in both public and private institutions that teach and deliver dental care. The strategic element is to reorient the services provided by general practices towards to goal of delivering a substantial reduction in the need to drill teeth, while maximizing the opportunity for a non-invasive remineralization approach that has been successfully demonstrated in in-vitro, in-vivo, and in small scale clinical trials.

Funding Amount $AUD 325,136.74

Funding Scheme NHMRC Project Grants

Notes Standard Project Grant