Cost-effectiveness Analysis of Periodontal Disease Control

Abstract

Cost-effectiveness analysis was used to evaluate alternative methods of periodontal disease control. The alternatives considered included non-surgical and surgical procedures as well as the use of antimicrobial agents. Data on costs were obtained from American Dental Association publications of average charges for periodontal services. The concept of quality-adjusted tooth-years (QATYs) was developed to provide an outcome measure which could be compared across treatments. The conclusions of this analysis are as follows: (1) Conservative non-surgical treatments for periodontal disease control not only have costs lower than surgical alternatives, as would be expected, but also maximize expected quality-adjusted tooth-years over a wide range of estimates; (2) antimicrobial therapy used as an adjunct to non-surgical treatment is likely to be both effective and cost-effective; and (3) quality of tooth-years is a critical consideration in the determination of outcome of periodontal treatment. For example, when tooth-years are not adjusted for quality, differences between treatments are diminished, and surgical treatment becomes as good as or better than more conservative treatments for some levels of disease severity.

A randomized controlled trial comparing surgical and non‐surgical periodontal therapy: a 3‐year clinical and cost‐effectiveness analysis

“…Except for the short‐term results on the same patient cohorts, there seem to be no publications comparing cost‐effectiveness of periodontal treatment modalities. Economic aspects of periodontal treatment can be investigated through different approaches such as cost‐effectiveness, cost‐utility or cost‐benefit analyses (Antczak‐Bouckoms & Weinstein , Gaunt et al. ).…”

Systematic Review of Publications on Economic Evaluations of Caries Prevention Programs

“…This is particularly the case in oral health. The concept of quality-adjusted tooth years (QATYs) was developed to provide an outcome measure which could be compared across treatments, as a dental variation of the QALY [Antczak-Bouckoms and Weinstein, 1987;Fyffe and Nuttall, 1995].…”

Pre‐treatment conceptions of periodontal disease and treatment in periodontal referrals

“…Matthews & McCulloch (1993) reported that patients perceived they would suffer more discomfort after surgical than non‐surgical periodontal therapy. It is not clear how patients input such information into the decision making process in relation to periodontal treatment;nevertheless, it has been suggested that patients strongly prefer non‐surgical treatments (Antczak‐Boukoms & Wenstein 1987, Antczak‐Boukoms & Tulloch 1991).…”

“…Few studies have quantified the perceptions which patients have of periodontal treatment and the outcomes of such treatment. Antczak‐Boukoms & Weinstein (1987) applied time trade‐off and standard gamble methods to determine the cost effectiveness of various periodontal treatments. They found that patients’ perceptions of the value of their teeth were important considerations which influenced them in their choice between various periodontal treatment options (Antczak‐Boukoms & Wenstein 1987).…”