Cost-effectiveness of atraumatic restorative treatment combined with the Hall Technique for managing dental caries in remote Indigenous children.

Abstract

Background: Indigenous children in remote Australia face significant disparities in oral health and have limited access to dental care. This study evaluated the cost-effectiveness of Atraumatic Restorative Treatment combined with the Hall Technique (ART-HT) compared to usual care.

Methods: A cost-effectiveness analysis using data from a 1-year ART-HT trial estimated dental caries status and costs from a health-provider perspective. Two scenarios were examined: (1) actual treatment costs and (2) minimum dental services. The incremental cost per decayed, missing, and filled teeth (dmft) prevented was calculated in AUD 2021 prices. A probabilistic sensitivity analysis was conducted.

Results: Among 228 children (ART-HT = 122; usual care = 106), deterministic analysis showed ART-HT required additional costs of $59.54 and $72.37 for scenarios 1 and 2, with 0.90 dmft prevented. Probabilistic sensitivity analysis revealed ART-HT resulted in better oral health outcomes with a mean dmft prevented of 0.58 (95% uncertainty interval: 0.09 to1.07). The mean additional cost per dmft prevented was $118.50 and $181.84 for scenarios 1 and 2.

Conclusions: ART-HT effectively managed dental caries in Indigenous children, providing better oral health outcomes compared to usual care, albeit with modest additional costs. This approach may improve access to culturally appropriate dental care in remote communities.