Methods and preliminary findings of a cost-effectiveness study of glass-ionomer-based and composite resin sealant materials after 2 yr.

The cost-effectiveness of glass-carbomer, conventional high-viscosity glass-ionomer cement (HVGIC) [without or with heat (light-emitting diode (LED) thermocuring) application], and composite resin sealants were compared after 2 yr in function. Estimated net costs per sealant were obtained from data on personnel time (measured with activity sampling), transportation, materials, instruments and equipment, and restoration costs for replacing failed sealants from a community trial involving 7- to 9-yr-old Chinese children. Cost data were standardized to reflect the placement of 1,000 sealants per group. Outcomes were the differences in the number of dentine caries lesions that developed between groups. The average sealant application time ranged from 5.40 min (for composite resin) to 8.09 min (for LED thermocured HVGIC), and the average cost per sealant for 1,000 performed per group (simulation sample) ranged from $US3.73 (for composite resin) to $US7.50 (for glass-carbomer). The incremental cost-effectiveness of LED thermocured HVGIC to prevent one additional caries lesion per 1,000 sealants performed was $US1,106 compared with composite resin. Sensitivity analyses showed that differences in the cost of materials across groups had minimal impact on the overall cost. Cost and effectiveness data enhance policymakers' ability to address issues of availability, access, and compliance associated with poor oral-health outcomes, particularly when large numbers of children are excluded from care, in economies where oral health services are still developing.

Minor oral surgery 'specialisation' in general dental practice.

A practitioner with 4 years' hospital oral surgery experience undertook minor oral surgery procedures within a general dental practice over a 4-year period. The variety of work completed is shown. The National Health Service fees for the procedures indicate that a practice limited to minor oral surgery is both practically and financially viable when referral fees and x-rays are included. Differences in the types of procedure undertaken by visiting 'specialist' practitioners and 'specialist' practices is highlighted. A population of 310,000 is suggested for a 'specialist' practice in minor oral surgery to be feasible.

Infection control in the Indian Health Service Dental Program: estimated costs and effects on productivity.

The dental literature contains many recommendations defining standards for infection control. Little information is available, however, documenting the cost of implementing these standards. This article describes the cost incurred by the Indian Health Service Dental Program in the Oklahoma area between 1985 and 1988 for infection control. During this period, comprehensive infection control recommendations were published for oral health programs serving Native Americans and data were collected on supply utilization. While productivity data were collected for that same time period do not support the premise that infection control practices lead to decreased clinical productivity, infection control supply costs did increase over fourfold during this period.