IADR Abstract Archives
Investment Cases for Oral Health: Development of a Primer
Objectives: Oral diseases are largely preventable but still affect billions of people worldwide. In low-income countries, there are high levels of unmet need, limited access to oral health care, and the burden of dental diseases has been increasing. The aim of this study was to exemplarily develop an oral health investment case for populations currently without basic oral health coverage.
Methods: A decision-analytic framework was developed to evaluate different scenarios for oral health investment, using Burkina Faso as a reference case. A Markov model was developed to estimate oral health benefits and costs of a program where 80% of the population would have basic oral health coverage. Several scenarios with different treatment technologies and oral health workforce (dentists, specialized nurses, community health workers) were compared. Oral health benefits were measured in terms of Disability-Adjusted Life Years (DALYs) avoided through prevention (fluoride toothpaste, oral hygiene education) and caries-related treatment.
Results: Based on simulations for a cohort of 5000 adolescents aged 15 to 19 years over a five years horizon, the Return On Investment (ROI) in oral health was highly dependent on the choice of human resource inputs and treatment technology. The price of fluoride toothpaste was identified as a key determinant, with price levels of 33% lower than current market prices required in order to break even upon investing in oral health.
Conclusions: Given available data and considering local context, our findings suggest that investment in oral health can be economically rewarding in low-income settings. However, careful choices about human resource and treatment technology inputs are required. The modeling of investment cases can help furthering evidence-informed oral health policy and prioritize future research activities to address existing information uncertainties.
Methods: A decision-analytic framework was developed to evaluate different scenarios for oral health investment, using Burkina Faso as a reference case. A Markov model was developed to estimate oral health benefits and costs of a program where 80% of the population would have basic oral health coverage. Several scenarios with different treatment technologies and oral health workforce (dentists, specialized nurses, community health workers) were compared. Oral health benefits were measured in terms of Disability-Adjusted Life Years (DALYs) avoided through prevention (fluoride toothpaste, oral hygiene education) and caries-related treatment.
Results: Based on simulations for a cohort of 5000 adolescents aged 15 to 19 years over a five years horizon, the Return On Investment (ROI) in oral health was highly dependent on the choice of human resource inputs and treatment technology. The price of fluoride toothpaste was identified as a key determinant, with price levels of 33% lower than current market prices required in order to break even upon investing in oral health.
Conclusions: Given available data and considering local context, our findings suggest that investment in oral health can be economically rewarding in low-income settings. However, careful choices about human resource and treatment technology inputs are required. The modeling of investment cases can help furthering evidence-informed oral health policy and prioritize future research activities to address existing information uncertainties.