RESUMO
A shift toward diagnostic and preventive dentistry in the last two decades is evident from the change in the number of dental procedures performed, as well as the change in the percentage of time spent performing different types of procedures. During the period 1975 through 1995, the average nominal fees for selected dental procedures increased. Once inflation was taken into account, however, the increase in the average real fees charged was more modest.
Assuntos
Assistência Odontológica/economia , Honorários Odontológicos/tendências , Adulto , Assistência Odontológica/estatística & dados numéricos , Assistência Odontológica/tendências , Profilaxia Dentária/economia , Restauração Dentária Permanente/economia , Dentaduras/economia , Diagnóstico Bucal/economia , Diagnóstico Bucal/estatística & dados numéricos , Economia , Honorários Odontológicos/estatística & dados numéricos , Honorários Médicos/tendências , Humanos , Inflação , Odontologia Preventiva/economia , Odontologia Preventiva/estatística & dados numéricos , Tratamento do Canal Radicular/economia , Curetagem Subgengival/economia , Extração Dentária/economia , Estados Unidos/epidemiologiaRESUMO
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.
