Cost-effectiveness of an individually tailored oral health educational programme based on cognitive behavioural strategies in non-surgical periodontal treatment.

AIM: The aim of this cost-effectiveness analysis (CEA), performed from a societal perspective, was to compare costs and consequences of an individually tailored oral health educational programme (ITOHEP) based on cognitive behavioural strategies integrated in non-surgical periodontal treatment compared with a standard treatment programme (ST). MATERIAL AND METHODS: A randomized (n = 113), evaluator-blinded, controlled trial, with two different active treatments, was analysed with respect to their costs and consequences 12 months after non-surgical treatment. Costs referred to both treatment costs and costs contributed by the patient. Consequences (outcome) were expressed as the proportion of individuals classified as having reached the pre-set criteria for treatment success after non-surgical treatment ("successful-NSPT"). RESULTS: More individuals in the ITOHEP group reached the pre-set criteria for treatment success than individuals in the ST group did. The CEA revealed an incremental cost-effectiveness of SEK1724 [€191.09; SEK9.02 = €1 (January 2007)] per "successful-NSPT" case, of which treatment costs represented SEK1189 (€131.82), using the unit cost for a dental hygienist. CONCLUSION: The incremental costs per "successful-NSPT" case can be considered as low and strengthens the suggestion that an ITOHEP integrated into non-surgical periodontal treatment is preferable to a standardized education programme.

The effects of income and education on ethnic differences in oral health: a study in US adults.

BACKGROUND: Ethnic differences exist in oral health. However, the causes of the differences have not been adequately addressed. The objective of this study is to examine the effect of socioeconomic position on ethnic differences in oral health. METHODS: Data were from the Third National Health and Nutrition Examination Survey conducted in the USA (1988-94). The effects of income and education on ethnic differences in perceived oral health, gingival bleeding, periodontitis and tooth loss were analysed using a series of regression models. RESULTS: The probabilities of poorer oral health were higher among African-American, Mexican-Americans and other ethnic groups than in White Americans. Adjusting for income and education resulted in a reduction in the ORs for having poorer perceived oral health (44%), tooth loss (29%), gingival bleeding (61%) and periodontitis (30%) among African-Americans than White Americans. Similar reductions in risk were observed among Mexican-Americans and other ethnic groups. CONCLUSION: The results indicate that education and income play an important role in ethnic differences in oral health. Despite the major impact of socioeconomic position, the results imply that there are causes additional to socioeconomic position for ethnic differences in oral health.

Fibrin sealant in surgery of patients with a hemorrhagic diathesis.

The utilization of fibrin sealants in patients with hemostatic disorders has hitherto been very limited. Our experiences from 40 major and 8 minor surgical procedures, 10 circumcisions and 118 tooth extractions in 106 patients with hemophilia A, B or von Willebrand's disease, almost exclusively of the severe form, respectively, demonstrate the benefits regarding reduction of blood loss and requirements for systemic replacement therapy. The literature on the use of fibrin sealants in this group of patients, which mainly concerns dental procedures, is reviewed and compared with our data. The importance of the composition of the glue is also discussed in detail.