title: The benefit of preventive procedures for high risk groups.
abstract: The clinical effectiveness of many caries prophylactic agents has been demonstrated but their public health value questioned from the viewpoint of economic efficiency. However, some groups within the population may have enhanced response to certain agents and for these subjects a more acceptable cost-value situation may occur. The effectiveness of agents may be measured by the extent to which they reduce operative treatment need. Therefore by costing treatment carried out in both groups in a clinical trial and adding, for the test group, the cost of prevention, the cost effectiveness of treatment plus prevention compared with treatment alone can be investigated. A computer was programmed to estimate from DMFS data, maintenance treatment carried out during clinical trials and that needed at the end to render subjects free of caries. Treatment was costed on the Resource Related Index. In an examination of two experimental clinical trials among adolescents it was found that supervised daily brushing in school with MFP dentifrice produced a 25 per cent reduction in DMFS over three years, but cost six and a half times as much as the operative treatment saved. However, for a high risk group of girls the cost was only two and a half times as much. When APF topical applications by hygienists were added to the same brushing programme it became even less economically efficient. Neither experimental programme was cost-effective for any group unless a weighting factor was introduced to take account of the desirablity of a sound as opposed to a filled tooth.
mesh_terms: D002648:Child; D003201:Computers; D003362:Cost-Benefit Analysis; D004245:DMF Index; D003731:Dental Caries / Q000191:economics* / Q000517:prevention & control*; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012306:Risk; D014100:Toothpastes / Q000627:therapeutic use
chemical_list: D014100:Toothpastes; D005459:Fluorides