An inspiring project
This project is the
inspiration of Associate Professor Wendell Evans, who has been
instrumental in the establishment of the Community Oral Health and
Epidemiology Research Unit, recognized as one of the research strengths
of the Faculty of Dentistry at the University of Sydney. A Caries
Management Policy and related strategy "The Caries Management System"
was developed by this research unit and adopted by the Bachelor of
Dentistry Curriculum in 2003. The Caries Management System has a twin
focus on the primary prevention of tooth decay and the non-invasive
management of non-cavitated teeth (secondary prevention). The Monitor
Dental Practice Program takes the key elements of this strategy and aims
to demonstrate the cost-effectiveness of this approach in private dental
practices.
The project is being
conducted by Dr Bradley Curtis (Faculty of Dentistry, University of
Sydney), and will form the basis for the degree of Doctor of Philosophy
at the University of Sydney, under the supervision of Associate
Professor Wendell Evans. Participating dental practices will be randomly
assigned to either treatment (those implementing the Caries Management
System) and control groups (those delivering usual care) and the
outcomes will be compared.
Aims of the project
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To compare the
effectiveness of programs offering standard care or structured
preventive care, in terms of reducing the number of decayed, missing,
and filled teeth.
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To determine the resource
use associated with both programs.
-
To conduct a
cost-effectiveness analysis.
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To determine patient and
dentist acceptability of the preventive program.
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To define the dimensions
of oral health from the perspective of the consumer.
-
To consider the
implementation issues surrounding the introduction of the preventive
program.
Project rationale
There has been growing
interest in economic evaluation, as health care decision makers have
sought data that will assist them in allocating scarce resources. While
the advent of fluoride has decreased new decay rates and slowed the
progression rates of existing disease, researchers have apparently not
been able to convey this message to clinicians, who still rely primarily
on surgical methods to control decay, which in turn, results in the
over-treatment of reversible lesions.
Economic evaluation is an increasingly important tool
for assessing the use of limited resources by identifying the
opportunity cost - the value of the best alternative use of a resource
that is foregone as a result of its current use. This project will
evaluate the costs and benefits of a structured preventive program (the
strategy of the Caries Management System), compared to the “usual” care
provided by a range of city, suburban, and rural dental practices in
fluoridated and non-fluoridated communities.
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