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Cited by 44Dental Health and Care UtilizationHealth Systems, Economic Evaluations, Quality of LifeOral microbiology and periodontitis research

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

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Nguyen, Tan Minh, Tonmukayakul, Utsana, Le, Long Khanh-Dao, Calache, Hanny, Mihalopoulos, Cathrine·2023·Applied Health Economics and Health Policy
DOI 10.1007/s40258-022-00758-5PMC PMC9834378
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Abstract

OBJECTIVES: To critically examine the methods used for full economic evaluations of preventive interventions for dental caries and periodontitis. METHODS: Published literature post-2000 was searched to April 2021. Based on a developed intervention classification framework for dental caries and periodontitis, only universal, selective or indicated interventions were included in this review. The Drummond 10-point checklist was used for quality appraisal. RESULTS: Of 3,007 unique records screened for relevance, 73 studies were reviewed. Most model-based studies (61/73) used cost-effectiveness analysis (49%) or cost-benefit analysis (28%). Trial-based studies (16/73) commonly used cost-effectiveness analysis (59%). Four studies used both economic evaluation methods. Sixty-four papers (88%) were on dental caries, eight papers (11%) focused on periodontitis, and one paper (1%) included both oral diseases; 72% of model-based and 82% of trial-based studies were of good quality. The most frequently investigated dental caries preventive interventions were water fluoridation (universal intervention; cost-saving or cost-effective), fissure sealant and fluoride varnish (selective and indicated interventions; cost-effectiveness outcomes were inconsistent). Supportive periodontal therapy with oral health education (indicated intervention; cost-effective) was the most frequently evaluated preventive intervention for periodontitis. Thirty percent of studies with a time horizon > 1 year did not apply an appropriate discount rate and 26% did not comprehensively discuss other important considerations beyond the technical analysis. CONCLUSIONS: Generic health outcome measures should be incorporated for economic evaluations on preventive interventions for dental caries and periodontitis, and an increased focus to prevent periodontitis using economic evaluation methods is needed to inform resource allocation and policy decision-making.

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  • EQ-5D-based outcomes may lack sensitivity in capturing oral health-specific improvements, which motivated a secondary OHIP-14 analysis.

    “a secondary analysis was undertaken using the OHIP- 14 to more directly assess changes in oral health- related quality of life, given concerns that EQ- 5D- based outcomes may lack sensitivity in capturing oral health- specific improvements [27-29].”

    From Economic Evaluation of the <scp>RETURN</scp> Intervention to Increase Routine Dental Attendance Among Disadvantaged Adults: Net Health Benefit ( <scp>QALYs</scp> ) and Patient Cost Outcomes From a Randomised Controlled Trial (2026) · cites this paper as [28]

    The Discussion (Interpretation and Implication of Outcome Measures; page unavailable) says QALY-based research has shown limited sensitivity to oral diseases. The Results (Derivation of Disability and Utility Weights; page unavailable) identifies EQ-5D-3L as one instrument used to derive QALYs, but the review does not establish that EQ-5D itself lacks sensitivity. The OHIP-14 secondary analysis is the citing authors’ own methodological choice, not a finding attributed to this review. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
Nguyen, T. M., Tonmukayakul, U., Le, L. K.-D., Calache, H., & Mihalopoulos, C.
Affiliations
  • Deakin University (AU)
  • Monash University (AU)
Corresponding author
Nguyen, Tan Minh
ORCID
Venue
Applied Health Economics and Health Policy
Publisher
Springer Science and Business Media LLC
Published
2022-09-12
Volume
21
Issue
1
Pages
53-70
ISSN
  • 1175-5652 (ISSN-L)
  • 1179-1896
DOI
10.1007/s40258-022-00758-5
PMC
PMC9834378
OpenAlex
W4295714209
Cited by
44
References
12
Citations by year
2026: 10 · 2025: 12 · 2024: 15 · 2023: 7
FWCI
1.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Applied Health Economics and Health Policy (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
Funders
  • National Health and Medical Research Council (APP1189802.)
  • Deakin University
Topics
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
Keywords
dental caries prevention, periodontitis prevention, economic evaluation, cost-effectiveness analysis, cost-benefit analysis, water fluoridation, pit and fissure sealants, fluoride varnish, periodontal maintenance, oral health education, discount rate
MeSH terms
Cost-Effectiveness Analysis, Cost-Benefit Analysis, Dental Caries, Fluoridation, Fluorides, Topical, Health Education, Humans, Oral Hygiene, Periodontitis, Pit and Fissure Sealants

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