title: The Monitor Practice Programme: is non-invasive management of dental caries in private practice cost-effective?
abstract: BACKGROUND
  The objective of this research was to assess the efficacy and cost-effectiveness of a non-invasive approach to dental caries management in private dental practice.
  
  
  METHODS
  Private dental practices from a variety of locations in New South Wales were randomly allocated to either non-invasive management of caries, or continue with usual care. Patients were followed for three years and caries incidence assessed. A patient-level decision analytic model was constructed to assess the cost-effectiveness of the intervention at two years, three years, and hypothetical lifetime.
  
  
  RESULTS
  Twenty-two dental practices and 920 patients were recruited. Within the clinical trial there was a significant difference in caries increment favouring non-invasive therapy at both two and three years. Efficacy was independent of age, gender, medical concerns, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices, in a variety of locations both urban and rural. Cost per DMFT avoided estimate was A$1287.07 (two years), A$1148.91 (three years) decreasing to A$702.52 in (medium) and A$545.93 (high) risk patients (three years).
  
  
  CONCLUSIONS
  A joint preventive and non-invasive therapeutic approach appears to be cost-effective in patients at medium and high risk of developing dental caries when compared to the standard care provided by private dental practice.
authors.affiliation: Community Oral Health and Epidemiology, Faculty of Dentistry, The University of Sydney, Australia. bradcurtis13@msn.com
authors.forename: B
authors.initials: B
authors.lastname: Curtis
authors.forename: E
authors.initials: E
authors.lastname: Warren
authors.forename: C
authors.initials: C
authors.lastname: Pollicino
authors.forename: R W
authors.initials: RW
authors.lastname: Evans
authors.forename: E
authors.initials: E
authors.lastname: Schwarz
authors.forename: A
authors.initials: A
authors.lastname: Sbaraini
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004245:DMF Index; D003661:Decision Support Techniques; D003729:Dental Care / Q000191:economics*; D003731:Dental Caries / Q000191:economics / Q000517:prevention & control*; D003733:Dental Caries Susceptibility; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007347:Insurance, Dental / Q000191:economics; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D011331:Private Practice / Q000191:economics*; D019035:Rural Health Services / Q000191:economics; D012737:Sex Factors; D016896:Treatment Outcome; D019037:Urban Health Services / Q000191:economics; D055815:Young Adult
chemical_list: D002327:Cariostatic Agents; D005459:Fluorides