Community Dental Health

cover art

Cover Date:
March 2012
Print ISSN:
0265 539X
Vol:
29
Issue:
1

Variations in caries diagnoses and treatment recommendations and their impacts on the costs of oral health care

Objective: To evaluate the reproducibility of caries detection and treatment planning among public health dentists and estimate the possible impact of their decisions on financial costs. Research design and settings: Thirty nine dentists working in the public health service of Piracicaba, São Paulo, Brazil made a combined visual–radiographic caries examination of 40 occlusal surfaces of extracted permanent teeth mounted on two dental mannequins and proposed treatment plans for each tooth. Histological validation then evaluated the diagnoses validity and the suitability of the treatment plans. Outcome measures: Inter-examiner agreement was calculated by Cohen’s Kappa statistics. The sensitivity and specificity of caries detection and treatment decision were calculated. The costs of dental treatment plans for public health system were calculated from a Brazilian public health service fee scale. Results: Inter-examiner agreement for caries detection was moderate (к=0.42) while for treatment decisions it was fair (к=0.29). The sensitivity and specificity were 0.69 and 0.65 for caries detection and 0.56 and 0.65 for treatment decision respectively. Dentists overestimated the presence and depth of carious lesions and there was a tendency to treat enamel lesions using invasive therapeutic procedures. Mean treatment cost across the two cases was 32US$ (range 9-65) while the histologically validated cost was 23US$. Conclusion: The variability in caries detection and treatment decision negatively affected the cost of the dental treatment.

Key words: oral diagnosis, inter-examiner variability, health care costs, economics, public health system

Article Price
£15.00
Institution Article Price
£
Page Start
25
Page End
28
Authors
R.P. da Silva, M.C. Meneghim, A.B. Correr, A.C. Pereira, G.M.B. Ambrosano, F.L. Mialhe

Articles from this issue

  • Title
  • Pg. Start
  • Pg. End

  1. Editorial - Dental Public Health in Action
  2. 3
  3. 3

  1. Acknowledgement of Referees
  2. 4
  3. 4

  1. A description of a specialist led primary care based oral surgery service
  2. 5
  3. 7

  1. The caries experience of 11 to 12 year-old children in Scotland and Wales and 12 year-olds in England in 2008-2009: Reports of co-ordinated surveys using BASCD methodology
  2. 8
  3. 13

  1. Assessment of caries experience in epidemiological surveys: a review
  2. 14
  3. 20

  1. Dental caries experience among 12-year-old children in Northwest Russia
  2. 20
  3. 24

  1. Variations in caries diagnoses and treatment recommendations and their impacts on the costs of oral health care
  2. 25
  3. 28

  1. Caries prevalence of 5, 12 and 15-year-old Greek children: A national pathfinder survey
  2. 29
  3. 32

  1. Associated factors of tooth wear among Malaysian 16-year-olds: a case-control study in Kota Bharu, Kelantan
  2. 33
  3. 38

  1. Factors associated with self-assessed masticatory ability among community-dwelling elderly Japanese
  2. 39
  3. 44

  1. The use of occlusal indices in high-impact literature
  2. 45
  3. 48

  1. Oral health status of a group of illicit drug users in Delhi, India
  2. 49
  3. 54

  1. Promoting Positive Health Behaviours – ‘Tooth Worm’ Phenomenon and its Implications
  2. 55
  3. 61

  1. Development and testing of a theory-based behavioural change intervention: A pilot investigation in a nursery school in a deprived area of Scotland
  2. 62
  3. 67

  1. The oral health status of Special Olympics athletes in Belgium
  2. 68
  3. 73

  1. Coincidence and awareness of oral parafunctions in college students
  2. 74
  3. 77

  1. Illness-related behaviour and sociodemographic determinants of oral health care use in Dabou, Côte d’Ivoire
  2. 78
  3. 84

  1. Number of teeth and its association with central obesity in older Southern Brazilians
  2. 85
  3. 89

  1. Perception of oral health related quality of life (OHQoL-UK) among periodontal risk patients before and after periodontal therapy
  2. 90
  3. 94

  1. Dental Fluorosis, Dental Caries, and Quality of Life Factors among Schoolchildren in a Colombian Fluorotic Area
  2. 95
  3. 99

  1. Relationship of Periodontal Disease to Pre-term Low Birth Weight Infants in a Selected Population - A Prospective Study.
  2. 100
  3. 105

  1. Dental Enamel Defects in Italian Children with Cystic Fibrosis: an observational study
  2. 106
  3. 109

  1. Orofacial pain symptoms and associated disability and psychosocial impact in community-dwelling and institutionalized elderly in Hong Kong
  2. 110
  3. 116

  1. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai
  2. 117
  3. 123

  1. Assessment of the relationship between perceptions of dental aesthetics and demand for orthodontic treatment in 10 – 11 year old school children in Birmingham, UK.
  2. 124
  3. 128