A Cost Analysis of Dental Treatment for Amelogenesis Imperfecta

Amelogenesis Imperfecta (AI) is a rare group of inherited disorders characterized by abnormal enamel formation that affects both the primary and permanent dentition. Three broad groups of AI can be distinguished: hypocalcified, hypoplastic, and hypomaturation. Treatment modalities for AI vary markedly depending on the clinical manifestations, but to date there are no studies exploring the potential economic impact of AI. Based on anecdotal reports the costs of dental treatment for this condition can have substantial financial impact on families. Objective: The purpose of this study was two-fold 1) develop an economic model for various treatment modalities for individuals with AI and 2) to apply the economic model to a sample of AI families . Method: A comprehensive review of literature and expert panel judgment was used to establish treatment modalities for AI. Chart reviews were completed to obtain sample treatment and costs information. Using this data, a model of treatment options and associated costs was then constructed. Results: Our sample included 24 patients that were treated for AI at the University of North Carolina: 62% female, 38% male. Seventeen percent had no dental insurance coverage while 42% had private dental insurance and 41% had public dental insurance. 71% received dental treatment in a hospital operating room setting. The mean costs of dental treatment, excluding hospital related costs, by stage of dental development were: $2915 SD±1215 in primary, $3630 SD±1830 in mixed and $6319 SD±6387 in permanent. Mean total dental treatment costs were $12,932 SD±8142 with the maximum being $22,235. If the child was treated in the hospital operating room, they incurred an additional mean cost of $5145. Conclusions: Dental treatment for individuals with Amelogenesis Imperfecta can have a significant financial impact on families, particularly those who are self pay or pay out pocket for much needed dental care.