Cost-effectiveness Analysis of Comprehensive Oral Health Care for Severe Early Childhood Caries in Urban Beijing, China.

OBJECTIVE: To evaluate the cost-effectiveness of comprehensive oral health care for severe early childhood caries (S-ECC) in urban Beijing, China. METHODS: A randomised cluster sampling method was used to select 187 children aged 3 to 5 years with S-ECC from two kindergartens in urban Beijing. Comprehensive oral health care and questionnaires for the parents/guardians were provided to the test group, while an oral health examination and questionnaires for the parents/guardians were provided to the control group. Data were collected and a Markov model was established for a cost-effectiveness analysis. RESULTS: One year later, 614 RMB yuan and 184 RMB yuan were needed for the control and test group, respectively, to reduce one average decayed tooth. The cost for the test group was continuously lower than for the control group during the 4-year simulation. The cumulative cost for the test group was lower than for the control group when the model was circulated for more than 1.5 years. At this time, the change of decayed teeth was stable in the test group. CONCLUSION: Comprehensive oral health care had extraordinary cost-effectiveness for S-ECC. The optimal time to process S-ECC may be after 1.5 years.

Utilisation of Oral Health Services and Economic Burden of Oral Diseases in China.

OBJECTIVE: To evaluate the use of oral health services, the economic burden of oral diseases and related influential factors in China. METHOD: Using the multistage, stratified, equal proportion, random sampling method in the 4th National Oral Health Survey of China conducted in 2015 to 2016, residents aged 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years respectively were recruited, clinically examined and answered a questionnaire. Utilisation of oral health services were assessed in all the age groups and the economic burden of oral diseases in the past 12 months were assessed in the 3 to 5 years and 35 to 74 year-old groups. Chi-squared tests, t tests, correlation analysis and a one-way ANOVA were used to determine the relationships of different factors with utilisation of oral health services and the economic burden of oral diseases. RESULTS: In the subject groups - 3 to 5 years, 12 to 15 years and 35 to 74 years - the prevalence of the utilisation of oral health services in the past 12 months was 14.6% (5,876/40,353), 23.6% (27,936/118,592), and 20.1% (2,708/13,461), respectively. In all three groups, receiving dental treatment was the most common reason for subjects' recent dental visit. The average dental cost in the past 12 months was 403.43 CNY (median = 100) for 3 to 5-year-old children and 850.83 CNY (median = 300) for adults aged 35 to 74 years old. Area, education and annual household income per person were the socio-economic influential factors. Oral health status, oral hygiene and attitudes to and knowledge of oral health affected the utilisation of oral health services and the economic burden of oral diseases. CONCLUSION: The percentage of dental service utilisation was relatively low, and the economic burden was high. The related factors for both utilisation of oral health services and the economic burden of oral diseases included living in area, educational attainment, household income, perceived oral health status, and oral hygiene.