There is a paucity of economic evaluations of prediction methods of caries and periodontitis—A systematic review

Abstract

Objectives Direct cost for methods of prediction also named risk assessment in dentistry may be negligible compared with the cost of extensive constructions. On the other hand, as risk assessment is performed daily and for several patients in general dental practice, the costs may be considerable. The objective was to summarize evidence in studies of economic evaluation of prognostic prediction multivariable models and methods of caries and periodontitis and to identify knowledge gaps (PROSPERO registration number: CRD42020149763). Material and methods Four electronic databases (PubMed, Web of Science, The Cochrane Library, NHS Economic Evaluation Database) and reference lists of included studies were searched. Titles and abstracts were screened by two reviewers in parallel. Full‐text studies reporting resources used, costs and cost‐effectiveness of prediction models and methods were selected and critically appraised using a protocol based on items from the CHEERS checklist for economic evaluations and the CHARMS checklist for evaluation of prediction studies. Results From 38 selected studies, six studies on prediction fulfilled the eligibility criteria, four on caries and two on periodontitis. As the economic evaluations differed in method and perspective among the studies, the results could not be generalized. Our systematic review revealed methodological shortcomings regarding the description of predictive models and methods, and particularly of the economic evaluation. Conclusions The systematic review highlighted a paucity of economic evaluations regarding methods or multivariable models for prediction of caries and periodontitis. Our results indicate that what we currently practice using models and methods to predict caries and periodontitis lacks evidence regarding cost‐effectiveness.

Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review

“…Our updated review noted there was a diversity of dental and generic health outcomes used in the studies included in this review and identified that there was sparse evidence for cost-effective interventions to prevent periodontitis [29,[114][115][116], which is a consistent finding from previous reviews [23][24][25][26][27][28][29]. Different outcome measures do not allow comparison between interventions or diseases to guide resource allocation.…”

Predicting Dental Caries in Young Children in Primary Health Care Settings

“…Implementation will also require assessing the acceptability and economic impact of establishing a risk-based approach to caries screening prevention. Even though there is a paucity of economic evaluations regarding caries prediction models (Fransson et al 2021), studies have shown risk-based prevention can be cost-effective in young children (Holst et al 1997). In addition, while the USPSTF (2021) recommends fluoride varnish (FV) for all children regardless of risk, and studies suggest that most pediatricians support providing oral health activities, fewer report engaging in these activities with all patients (Quiñonez et al 2014).…”

Advancing Quality in Health Economics and Dentistry: A Comprehensive Review

“…Economic evaluations serve as a pillar in the enhancement of dental-care quality, providing a systematic framework for assessing the cost-effectiveness of interventions. By integrating economic considerations into decision-making processes, practitioners and policymakers can optimize resource allocation, confirming that limited resources are directed towards interventions that yield the maximum benefit [18].…”