Table 2.
The categories of preventive interventions that were economically evaluated for dental caries and periodontitis
| Preventive intervention description | Number of economic evaluations N = 100 (%) |
Target oral disease | Economic evaluation outcome | Overall quality of studies* | |
|---|---|---|---|---|---|
| Universal interventions (N = 28) | |||||
| 20% sugar-sweetened beverages tax vs. no intervention [86, 87] | 2 | (2%) | Dental caries | Cost-effective or Cost-saving | Good |
| Bacterial screening saliva testing vs. standard care [91] | 1 | (1%) | Dental caries | N/S | Moderate |
| Ban on sugar-sweetened beverages sales vs. no intervention [88] | 1 | (1%) | Dental caries | Cost-saving | Good |
| Fluoridation of toothpastes vs. no intervention [83] | 1 | (1%) | Dental caries | Cost-saving | Moderate |
| Front-of-package food labelling vs. no intervention [89] | 1 | (1%) | Dental caries | Cost-effective | Good |
| Increasing the use of chewing gum vs. no intervention [90] | 1 | (1%) | Dental caries | Cost-saving | Good |
| Interleukin-1 genetic testing vs. standard care [53] | 1 | (1%) | Periodontitis | N/S | Good |
| Milk fluoridation vs. no intervention [81, 82, 85] | 3 | (2%) | Dental caries | Cost-effective | Good |
| Salt fluoridation vs. no intervention [80, 85] | 2 | (2%) | Dental caries | Cost-effective | Good |
| Water fluoridation vs. no intervention [55, 67, 68, 70–79, 84, 85] | 15 | (12%) | Dental caries and periodontitis# | Cost-effective or Cost-saving | Moderate |
| Selective interventions (N = 29) | |||||
| Targeted postage of oral hygiene products vs. no intervention [95] | 1 | (3%) | Dental caries | N/S | Low |
| Targeted pre/primary school-based dental check-up vs. standard care [94] | 1 | (3%) | Dental caries | Cost-effective | Good |
| Targeted pre/primary school-based fluoride varnish by dental/non-dental primary care providers with/without dental screening [44, 54, 61, 96] | Dental caries | ||||
| vs. counselling [44] | 2 | (7%) | Not cost-effective or N/S | Good | |
| vs. no intervention [54, 61] | 2 | (7%) | Cost-effective or N/S | Moderate | |
| vs. standard care [96] | 1 | (3%) | Cost-effective | Moderate | |
| Targeted primary school-based fissure sealant program with/without fluoride mouthrinse (intervention) | Dental caries | ||||
| vs. no intervention [59, 84, 85, 97, 98] | 5 | (17%) | Cost-effective or Cost-saving or N/S | Moderate | |
| vs. standard care [69, 99, 100] | 4 | (14%) | Cost-effective or N/S | Good | |
| vs. targeted school-based toothbrushing program [42] | 1 | (3%) | N/S | Good | |
| Targeted primary school-based fissure sealant program (comparator) | Dental caries | ||||
| All seal vs. risk-based [98, 101] | 2 | (7%) | N/S | Moderate | |
| No intervention vs. risk-based [98, 101] | 2 | (7%) | Not cost-effective | Moderate | |
| Targeted primary school-based fluoride gel vs. no intervention [85] | 1 | (3%) | Dental caries | N/S | Good |
| Targeted primary school-based fluoride mouth rinse vs. no intervention [85] | 1 | (3%) | Dental caries | Cost-effective | Good |
| Targeted supervised toothbrushing program vs. no intervention [42, 54, 85] | 2 | (7%) | Dental caries | N/S | Moderate |
| Targeted telehealth or home visit oral health education vs. standard care [57, 84, 93] | 3 | (10%) | Dental caries | Cost-saving or Cost-effective | Moderate |
| Targeted community-based group oral health education vs. chairside oral health education [92] | 1 | (3%) | Periodontitis | Cost-saving | Good |
| Indicated interventions (N = 42) | |||||
| Artificial intelligence for intra-oral radiographic detection of dental caries vs. no intervention [49] | 1 | (2%) | Dental caries | Cost-effective | Good |
| Oral prophylaxis and oral health education vs. fissure sealant and fluoride varnish [103] | 1 | (2%) | Dental caries | Not cost-effective | Moderate |
| Fluoride and xylitol supplement, oral prophylaxis and fluoride/chlorhexidine varnish vs. standard care [60, 107] | 2 | (5%) | Dental caries | N/S | Good |
| Fissure sealant vs. no intervention [41, 45–47] | 5 | (12%) | Dental caries | N/S | Moderate |
| Fluoride varnish vs. fissure sealant [40, 41] | 2 | (5%) | Dental caries | Cost-effective or Not cost-effective | Moderate |
| Fluoride varnish vs. standard care [48, 52, 62, 105, 106, 112] | 6 | (14%) | Dental caries | N/S | Good |
| Minimally invasive dentistry (intervention) | Dental caries | ||||
| vs. no intervention [104] | 1 | (2%) | N/S | Good | |
| vs. standard care [63–65, 104, 105] | 5 | (12%) | Not cost-effective or N/S | Good | |
| Standard care vs. minimally invasive dentistry [104] | 1 | (2%) | Dental caries | Not cost-effective | Good |
| Slow releasing fluoride glass devices program [84] | 1 | (2%) | Dental caries | Cost-saving | Low |
| Resin infiltration vs. fluoride varnish and/or oral health education [50] | 1 | (2%) | Dental caries | N/S | Moderate |
| Varied intervals of dental check-ups e.g., 3-, 9-, 12-, 24-, 36-monthly, risk-based | Dental caries | ||||
| vs. standard care [58, 111] | 7 | (17%) | N/S | Good | |
| 24-monthly vs. risk-based [58] | 1 | (2%) | Cost-effective | Good | |
| Regular supportive periodontal therapy | Periodontitis | ||||
| vs. irregular supportive periodontal therapy [109, 110] | 2 | (5%) | N/S | Moderate | |
| vs. tooth removal and implant crown replacement [110] | 1 | (2%) | N/S | Good | |
|
Supportive periodontal therapy by dental specialist vs. general dental practitioner [108] |
1 | (2%) | Periodontitis | N/S | Good |
| Varied intervals of supportive periodontal therapy and standard oral health education (e.g., 12-monthly) | Periodontitis | ||||
| vs. standard care [102] | 1 | (2%) | Cost-saving | Good | |
| Varied intervals of supportive periodontal therapy and tailored oral health education (e.g., 6-monthly, 12-monthly, risk-based) | Periodontitis | ||||
| 6-monthly vs. standard care [102] | 1 | (2%) | N/S | Good | |
| 12-monthly vs. standard care [102] | 1 | (2%) | N/S | Good | |
| Risk-based vs. standard care [102] | 1 | (2%) | N/S | Good | |
N = total number of economic evaluations, N/S not stated, Standard care refers to treatment as usual with 6-monthly dental check-ups
#Only one study on water fluoridation economically evaluated dental caries and periodontitis [70]
*Overall quality of studies using the Gonzalez-Perez (2002) criteria [38] for the Drummond 10-point checklist [34]