The aim was to determine the association between baseline factors, such as oral health-relatedbehavior, attitudes, knowledge and beliefs in relation to caries increment during a randomizedclinical trial (RCT). A further aim was to evaluate treatment costs and health outcomes during andafter the RCT.
In Pori Finland, 11- to 12-year-old children with active initial caries lesion(s) participated inthe RCT in 2001–05. The experimental group (n=250) received multiple measures for controllingcaries. The control group (n=247) received standard dental care. In 2005–08, all received standarddental care. Regression analyses were used to study the associations between behavioral factorsand caries increment. Cost-effectiveness analysis was conducted (trial period), and costs andhealth outcomes as well as dental service utilization were evaluated (post-trial period).
In the experimental group, brushing teeth twice a day was indicative of developing no newcaries lesions, whereas eating candy at least once a day, predicted new lesions. In the experimentaland control groups, lack of concern about cavities and lack of knowledge about mother’s dentalhealth predicted new caries lesions. The average incremental cost for averting one DMF surfacewas €34. The experimental regimen was more effective and more costly than the standard dentalcare. The total costs decreased year after year. The mean total cost per adolescent was lower andthe clinical outcome was better among the former participants in the experimental group. Theutilization of dental services was significantly more regular among the former participants in thisgroup.
It may be feasible to control caries more effectively by affecting toothbrushing, candy eatingand oral health-related attitudes, as preventive procedures may be ineffective if those factors arenot in order. It is important to discuss oral health-related topics in families, because this mayimprove the oral health-related behavior of children. Cost-effectiveness of regimen used for theexperimental group may be improved by division of work or by selective reduction of preventiveprocedures. Well-timed caries control can decrease treatment cost and yield long-termimprovement of dental health.
