Title: 0804 - Economic Evaluation of Early Caries Detection in Primary Teeth After 1-year Follow-up


Mariana Braga (Presenter)
University of Sao Paulo

Isabela Floriano, University of Sao Paulo
Gabriela Manco Machado, University of Sao Paulo
Renata Antonangelo Gomes, University of Sao Paulo
Daniela Raggio, University of Sao Paulo
Fausto Mendes, University of Sao Paulo
Amiram Gafni, McMaster University
Steve Birch, McMaster University


Objectives: The detection of early caries lesions has been advocated as a non-operative intervention aimed at avoiding further more expensive treatments. This study investigated the cost effectiveness of detecting and treating initial caries lesions in primary molars for children who are seeking for dental treatment based on a 1 year follow up.

Methods: Children were randomized to one strategy of caries detection: detecting only moderate and advanced lesions or alternatively including initial lesions and the assessment of caries activity status as a reason to treat. This is an ongoing study (CARDEC-02/NCT02473107) and for these analyses, children were followed for 1 year. The primary endpoint was the number of new operative treatments required during the follow-up period. Direct and indirect costs related to all interventions were collected. The endpoint was compared between groups using t-tests and costs using a bootstrap regression analysis. The perspective of the analysis was the Brazilian dental service. Simulations were used to investigate the uncertainties related to the costs and effects.

Results: 260 children were included in the study and 221 children (85%) were analyzed after 1-year. Both groups needed similar number of new interventions (p=0.86). On average, the program including detection of initial lesions costs U$196.75±218.41 per patient while the program aimed at moderate or advanced lesions costs per patient US189.31±213.72(p=0.95). Exploring the uncertainties, the probability for the alternative program to have a superior effect associated with a reduced cost compared to that focused only on cavities would be close to 30%. A superior effect linked to higher costs could be expected in 20% of distribution.

Conclusions: After 1 year of implementation, only 50% of simulated cases could be benefitial using the alternative strategies entailing no or reduced extra costs. More long term results (i.e., second year follow up) might provide more definitive direction.


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This abstract is based on research that was funded entirely or partially by an outside source:
CNPq (203632/2017-6; 309817/2015-3; 448013/2014-2), FAPESP (2013/27206-8), CAPES

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: None

Group Authors: CARDEC-trials Collaborative Group