Costing dental treatment in primary teeth: the impact of deprivation

Dental treatment in children costs the UK NHS £66m per year. A five year cohort study was designed to investigate the effects of different treatment modalities on various outcome measures including cost. Objectives: To investigate the costs to the UK NHS of dental care in children by treatment modality, deprivation factor and other demographic factors. Methods: As part of a 5-year cohort study in children aged 5-6 years at start parents returned treatment and attendance records for all dental visits for the duration of the study. Demographics, deprivation indicators, caries and treatment modality data were also collected. Cost data was taken from the Dental Practice Board (2005) fee scales and applied to the parent-collected data for each child. Costs were comprised of capitation payments and payments for additional treatments. Spreadsheet models were constructed to estimate overall costs based on recorded treatments. Linear and logistic regression was undertaken to determine the extent to which deprivation (Townsend scores 4, 5) and other factors affected costs. Results: Complete data were available for 1885 children of whom 65 had no recorded dental visits. Those children who had a mixture of intervention and non-intervention for their caries (≤225) had significantly higher costs than those children who had all caries treated (≤209), all caries untreated (≤201), or no caries (≤190). The regression analysis demonstrated that actual costs were dependent on capitation, deprivation and presence of fluoridation, while the extent of treatment costs was dependent on whether the area was fluoridated. Conclusion: Capitation represents the major component of overall cost, while relative deprivation also impacts on cost but has no significant effect on treatment costs. The project was funded by Primary Dental Care scheme of the NHS research and development programme.