Evidence map›Paper›PMID 38548263›Full record

ArticleAcademic pediatrics2024

A Cost-Effectiveness Analysis of Population-Level Dental Caries Prevention Strategies in US Children.

Cara B Janusz, Tran T Doan, Acham Gebremariam, Angela Rose, Martha A Keels, Rocio B Quinonez, George Eckert, Emily Yanca, Margherita Fontana, Lisa A Prosser

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Academic pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.4field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Review
  6. Review
  7. Dental Caries: The Way Forward.JDR clinical and translational research · 2025
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Cara B JanuszSusan B. Meister Child Health and Evaluation Research (CHEAR) Center (CB Janusz, T Doan, A Gebremariam, A Rose, and LA Prosser), Department of Pediatrics, University of Michigan, Ann Arbor, Mich. Electronic address: cjanusz@wakehealth.edu.
Tran T DoanSusan B. Meister Child Health and Evaluation Research (CHEAR) Center (CB Janusz, T Doan, A Gebremariam, A Rose, and LA Prosser), Department of Pediatrics, University of Michigan, Ann Arbor, Mich; Department of Health Management and Policy (T Doan and LA Prosser), School of Public Health, University of Michigan, Ann Arbor, Mich; Department of Pediatrics (T Doan), University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Acham GebremariamSusan B. Meister Child Health and Evaluation Research (CHEAR) Center (CB Janusz, T Doan, A Gebremariam, A Rose, and LA Prosser), Department of Pediatrics, University of Michigan, Ann Arbor, Mich.
Angela RoseSusan B. Meister Child Health and Evaluation Research (CHEAR) Center (CB Janusz, T Doan, A Gebremariam, A Rose, and LA Prosser), Department of Pediatrics, University of Michigan, Ann Arbor, Mich.
Martha A KeelsDepartment of Pediatrics (MA Keels), Duke University, Durham, NC; Division of Pediatric Dentistry and Public Health (MA Keels and RB Quinonez), University of North Carolina Adams School of Dentistry, Chapel Hill, NC.
Rocio B QuinonezDivision of Pediatric Dentistry and Public Health (MA Keels and RB Quinonez), University of North Carolina Adams School of Dentistry, Chapel Hill, NC.
George EckertDepartment of Biostatistics and Health Data Science (G Eckert and E Yanca), Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Bloomington, Ind.
Emily YancaDepartment of Biostatistics and Health Data Science (G Eckert and E Yanca), Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Bloomington, Ind.
Margherita FontanaDepartment of Cariology (M Fontana), Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Mich.
Lisa A ProsserSusan B. Meister Child Health and Evaluation Research (CHEAR) Center (CB Janusz, T Doan, A Gebremariam, A Rose, and LA Prosser), Department of Pediatrics, University of Michigan, Ann Arbor, Mich; Department of Health Management and Policy (T Doan and LA Prosser), School of Public Health, University of Michigan, Ann Arbor, Mich.
Roseman University of Health Sciences · USIndiana University Bloomington · USUniversity of North Carolina at Chapel Hill · USUniversity of Michigan · USUniversity of Pittsburgh · US

Funding

Predicting Caries Risk in Underserved Toddlers in Primary Healthcare SettingsU01DE021412 · NIDCR · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Margherita R Fontana · 2011 to 2026
$24.0M
NIDCR NIH HHS U01 DE021412
6 · The paper itself

Abstract

objectiveTo improve oral health disparities and outcomes among US children impacted by dental caries, there is a need to understand the cost-effectiveness of a targeted, risk-based versus universal-based approach for caries prevention.

methodsHealth and economic outcomes were simulated in a cohort of 50,000 US children aged 1-18 years, comparing current practice (CP) to risk-based-prevention (RBP) and prevention-for-all (PFA) strategies using health care sector and limited societal perspectives. Prevention included biannual oral health exams and fluoride varnish application, and one-time dental sealant placement. The primary outcome is the cost-effectiveness ratio (ICER), defined as the additional cost per quality-adjusted life year (QALY) gained when comparing each strategy to the next least costly one.

resultsFor RBP compared to CP, the ICER was US$83,000/QALY from the health care sector perspective; for PFA compared to RBP the ICER was US$154,000/QALY. Using a limited societal perspective that includes caregiver time spent attending dental or medical setting visits, RBP compared to CP yielded a ratio of $119,000/QALY and PFA compared to RBP was $235,000/QALY. Results were most sensitive to changes in the probability of pain from an episode of dental caries, costs for prevention and restoration, and the loss in health-related quality of life due to dental caries pain. Scenario analyses evaluating a reduced intensity of prevention services yielded lower ICERs.

conclusionUsing a risk-based approach that identifies and targets children at increased risk for dental caries to guide the delivery of prevention services represents an economic value similar to other pediatric prevention programs.

Indexed as

Dental CariesFluorides, TopicalPit and Fissure SealantsQuality-Adjusted Life YearsAdolescentChildChild, PreschoolCost-Effectiveness AnalysisFemaleHumansInfantMaleUnited StatesFluorides, TopicalPit and Fissure Sealantscavitieschild healtheconomic evaluationoral healthprevention

Identifiers

PMID38548263
PMCPMC11193632
OpenAlexW4393204408

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.