Methods: A convenience sample of 65 participants were recruited and asked to imagine that they had 20 years to live. Four dental scenarios were presented: very stable lower denture; lower denture stays in mouth but is not very stable; very unstable lower denture; and implant-supported lower denture. For each scenario, participants were asked how many months/years of their remaining life would they be wiling to give up for a full set of natural teeth. Oral cancer was added as a positive control scenario. Descriptive statistics were used and quality-adjusted-life-years (QALYs) calculated. Cost-effectiveness ratios were calculated using treatment cost estimates obtained from published reports.
Results: Participants were willing to give up some years of life in order to have a comfortable, stable denture. As the prosthesis had less stability and function, participants were willing to give up additional months of life. For the very unstable lower denture scenario, participants reported willingness to pay, on average, $21,741, to obtain treatment that could provide for a comfortable, stable lower denture. Cost of ISMO versus mandibular conventional dentures was $11,552 as compared to $8,527 for a difference of $4,593. As expected, compared to an ISMO, the cost effectiveness ratio was much more favorable for a very unstable mandibular conventional denture ($3,135 per QALY) versus a very stable mandibular conventional denture ($23,860 per QALY).
Conclusion: Preliminary results suggest that ISMOs are cost-effective and participants would be willing to pay for an ISMO if the prosthesis could provide additional esthetics, stability and comfort.