Health care savings from microbiological caries risk screening of toddlers: a cost estimation model.
OBJECTIVE
Modeling new biomedical technologies and determining their expected cost is necessary before initiating formal clinical trials. This paper estimates an economic model for the potential cost impact of microbiological screening of toddlers for caries risk compared to the traditional method of managing pediatric caries.


METHODS
Potential cost savings were calculated based on screening test properties (sensitivity and specificity) derived from a population of 1,180 children aged 1 to 3 years with a caries prevalence of 15 percent. An algorithm was then developed to allocate prevalent and anticipate incident caries, treatment effectiveness assumptions, and existing regional treatment costs.


RESULTS
The cost analysis model conservatively predicts savings of 7.3 percent from screening and early intervention. Cumulative dental treatment costs for a child at age 4 years are $367.90 if the child has been screened and $396.70 otherwise. The model further predicts that cost savings increase significantly as caries prevalence increases.


CONCLUSIONS
Microbiologic risk assessment for pediatric caries may be an example of a preventive public health screening technique that results in both clinical benefits and cost savings. If the model is validated by randomized clinical trials, microbiologic screening could be used by pediatric primary care providers to identify toddlers who require early referral to dentists for further risk assessment and early caries management.
Zavras
A I
AI
Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA. zavras@hms.harvard.edu
Edelstein
B L
BL
Vamvakidis
A
A
D000465:Algorithms; D001419:Bacteria / Q000254:growth & development*; D002675:Child, Preschool; D017046:Cost Savings; D003365:Costs and Cost Analysis; D004245:DMF Index; D019140:Dental Care for Children / Q000191:economics*; D003731:Dental Caries / Q000382:microbiology* / Q000517:prevention & control / Q000628:therapy; D003733:Dental Caries Susceptibility; D005544:Forecasting; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D008403:Mass Screening / Q000191:economics*; D018803:Models, Economic; D015995:Prevalence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome