Cost-effectiveness of caries preventive interventions – a systematic review
Open accessAbstract
OBJECTIVE: The primary purpose of this study was to assess the cost-effectiveness of caries preventive interventions. MATERIAL AND METHODS: A systematic review was conducted, following the PRISMA Statement. Four electronic databases were searched (final search 16 March 2020). Studies fulfilling the inclusion criteria were independently critically appraised, by two reviewers in parallel. Data from each included study were extracted and tabulated: the analysis used a narrative approach to present the results of the estimated cost-effectiveness. RESULTS AND CONCLUSIONS: Twenty-six publications fulfilled the inclusion criteria and were of low or moderate risk of bias. Ten publications were economic evaluations, directly based on empirical studies, and the other 16 were modelling studies. Most of the studies concerned interventions for children and the most common were analyses of fluoride varnish and risk-based programs. Some of the studies showed both reduced cost and improved outcomes, but most studies reported that the improved outcome came with an additional cost. The results disclosed several cost-effectiveness evaluations of caries preventive interventions in the literature, but these target primarily children at high risk. There is a scarcity of studies specifically targeting adults and especially the elderly.
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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 [29]
The Discussion says few reviewed studies used QALYs, but does not say that EQ-5D lacks sensitivity to oral-health improvements. Searches for EQ-5D sensitivity and OHIP-14 found no passage addressing that concern; the secondary analysis is described as the citing authors’ own decision. (LLM, conf=0.73)
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- Authors
- Davidson, T., Blomma, C., Bågesund, M., Krevers, B., Vall, M., Wärnberg Gerdin, E., & Tranæus, S.
- Affiliations
- Linköping University (SE)
- Malmö University (SE)
- Odontological Research Unit, Public Dental Service, Region Örebro County, Örebro, Sweden
- Corresponding author
- Davidson, Thomas
- Venue
- Acta Odontologica Scandinavica
- Published
- 2020-12-28
- Volume
- 79
- Issue
- 4
- Pages
- 309-320
- ISSN
- 0001-6357 (ISSN-L)
- 1502-3850
- OpenAlex
- W3117063625
- Cited by
- 23
- References
- 51
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 6
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Acta Odontologica Scandinavica (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Diva portal (Dalarna University Library) (submittedVersion, other-oa)
- Funders
- Swedish Research Council for Health, Working Life and Welfare (201800527)
- 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 › Orthodontics › Dental materials and restorations
- Keywords
- dental caries prevention, cost-effectiveness, fluoride varnish, economic evaluation, caries risk assessment, adults and elderly
- MeSH terms
- Adult, Aged, Child, Cost-Benefit Analysis, Dental Caries, Dental Caries Susceptibility, Fluorides, Humans
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