title: A retrospective analysis of the costs associated with the treatment of nursing caries in a remote Canadian aboriginal preschool population.
abstract: Nursing caries is a specific form of rampant dental caries affecting the majority of preschool aboriginal children who live in the Province of Manitoba, Canada. Since the majority of these individuals live in remote regions of the province access to dental treatment is difficult, resulting in long delays in the provision of treatment and, most likely, significant morbidity associated with dental pain and oral infection. Travel to distant centres for treatment under general anesthesia by pediatric dentists has become the usual method by which treatment is provided to the majority of affected children. We believed that this was an expensive method of providing these necessary services and our purpose was to document all costs associated with the treatment of nursing caries in this population. We analyzed the records of 884 children who were treated for nursing caries between 1980 and 1988 in Manitoba and collected data for costs in the following categories: travel, lodging, medical, dental, hospital and nursing. Our results show that the remote band groups had significantly higher costs (P < 0.001) than groups which were located closer to treatment centres. The costs which accounted primarily for this significant difference were travel and medical costs associated with hospitalization and the administration of general anesthesia. Our results support the need for the redeployment of resources on the basis of regional need and the development of community-based preventive programs and treatment programs which will significantly reduce the incidence of nursing caries in preschool Canadian aboriginal children.
authors.affiliation: Department of Preventive Dental Science, Faculty of Dentistry, University of Manitoba, Winnipeg, Canada.
authors.forename: A R
authors.initials: AR
authors.lastname: Milnes
authors.forename: C W
authors.initials: CW
authors.lastname: Rubin
authors.forename: M
authors.initials: M
authors.lastname: Karpa
authors.forename: R
authors.initials: R
authors.lastname: Tate
mesh_terms: D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000191:economics; D000768:Anesthesia, General / Q000191:economics; D001903:Bottle Feeding / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004245:DMF Index; D003695:Delivery of Health Care / Q000191:economics; D003729:Dental Care / Q000191:economics* / Q000706:statistics & numerical data; D003731:Dental Caries / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D003796:Dental Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007198:Indians, North American; D007223:Infant; D004930:Inuit; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008507:Medically Underserved Area; D012189:Retrospective Studies