IADR Abstract Archives
Preventing Caries-Related Treatment and Costs in Children: Fifteen-Year Longitudinal Analysis
Objectives: Tooth extraction under general anaesthesia due to caries is the leading cause of hospital treatment for children under 9 in England, costing National Health Service (NHS) >£25 million. In contrast, a population level caries strategy including supervised toothbrushing with fluoridated toothpaste by children in schools has led to significant improvements in Scotland. As that programme was not randomised, it is difficult to make exact estimates of benefits. Therefore, this study aims to follow-up the cohort who were, as 534, 5-year-olds randomised within the Tayside Brushing Study in 1997 in Scotland, to be either in control classes, or intervention classes, in order to estimate costs and benefits 15 years later of the supervised school brushing programme.
Methods: During the 2-year trial, pupils in intervention classes brushed daily with toothpaste containing 1,000 ppm fluoride (as sodium monofluorophosphate) and 0.13% calcium glycerophosphate, with home supplies. At trial end, significant health benefits were found. With permission, NHS dental records,1999 to 2012 were obtained. In 2012 the “children” were aged 20 years; 91% of records were available. For this cost of illness analysis, treatment costs were discounted at 3.5% annually.
Results: Over the 15 years’ follow-up, the brushing group had lower costs of caries-related dental treatment: £14,044, compared with the control group: £15,528. Cost of treatment in the per protocol group was £12,469; which was 20% lower for participants who brushed their teeth at school every day with fluoride toothpaste. The research study employed brushing supervisors, the costs of the intervention were £30 per child.
Conclusions: The 2-year school brushing programme led to reduced treatment for dental caries throughout childhood which were measurable 15 years later, at age 20. If the costs of the brushing programme were reduced to £13 per child, as possible in a public health programme, total intervention plus treatment costs would be lower than controls.
Methods: During the 2-year trial, pupils in intervention classes brushed daily with toothpaste containing 1,000 ppm fluoride (as sodium monofluorophosphate) and 0.13% calcium glycerophosphate, with home supplies. At trial end, significant health benefits were found. With permission, NHS dental records,1999 to 2012 were obtained. In 2012 the “children” were aged 20 years; 91% of records were available. For this cost of illness analysis, treatment costs were discounted at 3.5% annually.
Results: Over the 15 years’ follow-up, the brushing group had lower costs of caries-related dental treatment: £14,044, compared with the control group: £15,528. Cost of treatment in the per protocol group was £12,469; which was 20% lower for participants who brushed their teeth at school every day with fluoride toothpaste. The research study employed brushing supervisors, the costs of the intervention were £30 per child.
Conclusions: The 2-year school brushing programme led to reduced treatment for dental caries throughout childhood which were measurable 15 years later, at age 20. If the costs of the brushing programme were reduced to £13 per child, as possible in a public health programme, total intervention plus treatment costs would be lower than controls.