The Cost and Effectiveness of School-Based Preventive Dental Care
The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five non-fluoridated communities. These children were examined at baseline and assigned to one of six treatment regimens. Four years later, 9,566 members of this group were examined again. Analyses of their dental examination data showed that dental health lessons, brushing and flossing, fluoride tablets and mouthrinsing, and professionally applied topical fluorides were not effective in reducing a substantial amount of dental decay, even when all these procedures were used together. Occlusal sealants prevented one to two carious surfaces in four years. Children who were especially susceptible to decay did not benefit appreciably more from any of the preventive measures than did children in general. Annual direct per capita costs were $23.00 for sealant or fluoride prophy/gel applications and $3.29 for fluoride mouthrinsing. Communal water fluoridation was reaffirmed as the most cost-effective means of reducing tooth decay in children. (Author)
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AFDH annual dental examinations average baseline grade level biweekly brushing brushing and flossing Chattanooga El Paso classroom effect classroom procedures clinic and classroom cohort and fluoridation Cohort Cohort Cohort combination of cohort comparison computed continuous residence sample cost of restoring COSTS PER CHILD covariance dental caries dental decay dentifrice differences DMFS increment scores DMFS score F-statistic fluoridated sites Fluoridation Status fluoride mouthrinsing fluoride prophy/gel applications Fluoride tablets four-year continuous residence FOUR-YEAR DMFS INCREMENTS Interval for Clinic intraschool correlation longitudinal control group mean DMFS increment Monroe Pierce County NIDR nonfluoridated sites number of children p-values Paso Hayward Minneapolis Percent Confidence Intervals preventive procedures radiograph Rand Corporation REDUCTIONS IN FOUR-YEAR regimen means reported rinse Robert Wood Johnson school-based preventive dental site-regimens six treatment regimens standard errors study's surfaces in four Surfaces Saved Table teachers tooth decay treatment effects unit of analysis water fluoridation Wichita Wood Johnson Foundation