Can organised dental care for children be both good and cheap?
- PMID: 9088701
- DOI: 10.1111/j.1600-0528.1997.tb00908.x
Can organised dental care for children be both good and cheap?
Abstract
Children's dental services evolved from emergency, pain-relieving and later amalgam-based care systems of the early and middle 20th century. The pattern of occurrence of dental caries is different today and young teenagers have very few teeth affected by caries. Restoration of lesions in permanent teeth, typically on occlusal or buccal/lingual surfaces, is technically simple. Paradoxically, dental students today are expected to master a vast amount of knowledge, including information on new dental materials and techniques. New dentists who choose to provide dental care for children as a career will spend most of their days placing fissure sealants, applying topical fluorides and inserting predominantly single-surface restorations. Because of their expensive training, new dentists will nevertheless expect high earnings, and this results in a high cost for children's dental care. The opportunity cost is other health services foregone. In developing countries where there are few dentists, they are almost not available for children at all. Costs could be reduced by reducing the number of interventions, and by reducing staff costs. Fewer interventions could be achieved by longer recall intervals: several studies and experience from places where this has been implemented indicate that is safe and effective. Widespread delegation of operative work to appropriately trained dental hygienists or therapists would reduce staff costs. Dental therapists are better substitutes for dentists in children's care because they are trained to do most of the clinical procedures that are necessary in children's dentistry. In Western Australia and South Australia, most dental care for children is provided by dental therapists. The costs of care are much lower and the outcome, as measured by caries experience and numbers of treated patients, is equivalent to or even better than European dentist-based services. Already, in some places, politicians and others are querying the need for organised children's dental care. Increased effectiveness will make continuation of children's dental services easier to sustain.
Similar articles
-
The FiCTION dental trial protocol - filling children's teeth: indicated or not?BMC Oral Health. 2013 Jun 1;13:25. doi: 10.1186/1472-6831-13-25. BMC Oral Health. 2013. PMID: 23725316 Free PMC article. Clinical Trial.
-
Evidence-based Clinical Practice Guideline for the Use of Pit-and-Fissure Sealants.Pediatr Dent. 2016 Oct 15;38(5):120-136. Pediatr Dent. 2016. PMID: 28206888
-
The impact of recent changes in the epidemiology of dental caries on guidelines for the use of dental sealants: clinical perspectives.J Public Health Dent. 1995;55(5 Spec No):302-11. doi: 10.1111/j.1752-7325.1995.tb02384.x. J Public Health Dent. 1995. PMID: 8854270 Review.
-
Variations in caries diagnoses and treatment recommendations and their impacts on the costs of oral health care.Community Dent Health. 2012 Mar;29(1):25-8. Community Dent Health. 2012. PMID: 22482245
-
Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents.Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003067. doi: 10.1002/14651858.CD003067.pub2. Cochrane Database Syst Rev. 2006. Update in: Cochrane Database Syst Rev. 2010 Mar 17;(3):CD003067. doi: 10.1002/14651858.CD003067.pub3. PMID: 17054158 Updated. Review.
Cited by
-
Establishing risk-based recall interval for caries management among 11-12-year-old Pakistani children.BMC Oral Health. 2022 Aug 13;22(1):349. doi: 10.1186/s12903-022-02383-z. BMC Oral Health. 2022. PMID: 35964068 Free PMC article.
-
The Moderating Role of Anticipated Regret and Product Involvement on Online Impulsive Buying Behavior.Front Psychol. 2021 Dec 17;12:732459. doi: 10.3389/fpsyg.2021.732459. eCollection 2021. Front Psychol. 2021. PMID: 34975621 Free PMC article.
-
Recall intervals for oral health in primary care patients.Cochrane Database Syst Rev. 2020 Oct 14;10(10):CD004346. doi: 10.1002/14651858.CD004346.pub5. Cochrane Database Syst Rev. 2020. PMID: 33053198 Free PMC article.
-
Minimally Invasive Dentistry Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries in Rural and Remote Aboriginal Communities: Protocol for a Randomized Controlled Trial.JMIR Res Protoc. 2018 Jul 25;7(7):e10322. doi: 10.2196/10322. JMIR Res Protoc. 2018. PMID: 30045834 Free PMC article.
-
Changing trend of caries from 1989 to 2004 among 12-year old Sardinian children.BMC Public Health. 2007 Mar 1;7:28. doi: 10.1186/1471-2458-7-28. BMC Public Health. 2007. PMID: 17331258 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical