BALMAIN, NSW, Australia: The prevention of caries has been, and still is, a major goal for the dental profession. A recent study published in Value in Health, the official journal of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), highlights the disparity between routine dental clinical practice and a model of care which is evidence-based in terms of diagnosis and preventive intervention.

The objective of a randomised controlled trial conducted by the University of Sydney Dental School was to review the efficacy and cost-effectiveness of a non-invasive approach to the management of dental caries within a variety of private dental practices in Australia.

The non-invasive programme was effective in reducing the incidence of new and recurrent decay over the three years of the study by more than 40 per cent. These results were independent of age, gender, medical status, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices. Further, it appears in patients categorised at medium to high risk of developing dental decay, that the programme was reasonably cost-effective when compared to existing dental care practice.

“Unfortunately, dental care has moved towards a more interventionist model—the current payment rebate and remuneration process is weighted towards rewarding fillings performed and crowns fitted,” said Associate Professor Wendell Evans, co-author of the study. “This newly adopted system for early decay diagnosis has opened opportunities for action to prevent cavities. The shift in resources towards 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 towards defining and potentially addressing the problem.”

(Edited by Claudia Salwiczek, DTI)