Cost-effectiveness of silver diamine fluoride on arresting primary tooth caries in child development center in Chiangkhong district, Chiangrai province
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This randomized controlled trial was to study cost-effectiveness of 38% silver diamine fluoride (SDF) combining dental health activities, on arresting dental caries in child development center in Chiangkhong district, Chiangrai province. Samples were 253 children aged 2-5 years old having at least one carious tooth of upper anterior teeth, were divided into 4 groups which were control group (no SDF application), applied only one time throughout the study (group 2), applied every 3 months (group 3), and applied every 6 months (group 4). The SDF applications were done by 2 trained dental nurses while carious lesion status was evaluated at 12 month by 2 calibrated dentists with single blind technique. The operating cost composing of labour and material costs, was collected from salary slip, dental material requisition form, and work planning then calculated to be cost of each group. The McNemar test and Pair-Matched Odds ratio were used to compare effectiveness of the application among 4 groups at 95% confidence interval and revealed cost-effectiveness as cost per arrested carious surface. All applied groups had significant higher arrested carious surfaces but no difference in the control group. Pair-Matched Odds ratios were 1.2 (CI 0.88-1.64), 12.8 (CI 7.67-21.21), 41.3 (CI 18.39-92.89) and 36.3 (CI 17.12-76.89), respectively. Both every 3 and 6 month-application arrested carious surfaces higher than one time application but there was no significant difference between them. While the cost-effectiveness were 79.8 and 44.9 baht per surface, respectively therefore every 6 month-application was more valuable.
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