Cost-effectiveness of silver diamine fluoride for the prevention and control of early childhood caries: a scoping review.

Abstract

Early childhood caries (ECC) is the presence of one or more decayed, missing, or filled teeth in children up to 71 months of age. Among the recommendations proposed by the World Health Organization to counteract this condition is the application of silver diamine fluoride (SDF). The aim of this research was to analyze the available information on the cost-effectiveness of SDF as a public health intervention in the prevention and control of ECC. This scoping review included articles published in English between 2008 and 2023 about the cost-effectiveness of SDF for pre-schoolers. Scientific journal databases (PubMed, Free Medical Journal, Science Direct, Springer Link, and Google Scholar) were searched using the following keywords: ECCs, effectiveness, cost, SDF, economic evaluation, caries, pre-school, infant, and minimal invasive treatment. The information extracted included author, year, objective, population, design, perspective of the analysis, options to be compared, time horizon, discount rate, costs, and effectiveness. We identified a total of 526 articles. Of these, 514 were excluded due to lack of relevance to the study objective, and 5 were duplicates. The final sample comprised 7 articles. The reported costs of SDF treatments from the perspective of healthcare practitioners ranged from $0.7 to $1,456, with an incremental cost-effectiveness ratio ranging from -$7.73 to -$518.50. SDF is a cost-effective treatment for public health interventions to prevent and control ECC in pre-schoolers.