Economic Evaluations of Preventive and Minimally Invasive Children's Dental Caries Procedures: A Scoping Review.

Abstract

Background: The WHO's Global Oral Health Action Plan towards 2030 suggests prioritizing cost-effective preventive and minimally invasive (MI) dental caries interventions as essential oral health care services. Given the high prevalence of dental caries among children, raising awareness of the limitations and research gaps of the existing economic evaluations assessing preventive and MI procedures is crucial. Therefore, this scoping review aimed to identify and map the relevant literature on economic evaluations for preventive and MI dental caries procedures among children under 12 years of age.

Summary: We conducted a systematic literature search using Medline, Embase, Scopus, Web of Science, Cochrane, LILACS, and PEDE up to December 31st, 2023. Two independent reviewers performed the screening and data extraction using the Covidence software. A third reviewer resolved disagreements. Inclusion criteria comprised full economic evaluations and full-text original articles published in peer-reviewed journals, in English, Spanish, or Portuguese, without any date restrictions. Data extraction included methodological characteristics items. We appraised the content reported using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist.

Key messages: Among 1,285 studies screened, 62 were selected for data extraction. Most studies conducted a cost-effectiveness analysis (98%, n = 61), and only 10% (n = 6) and 3% (n = 2) conducted a cost-benefit and cost-utility analysis, respectively. The majority of studies evaluated sealants (32%, n = 20) and fluoride varnish (24%, n = 15), and only three assessed the cost-effectiveness of silver diamine fluoride. None of the included studies reported the CHEERS item related to community engagement. Moreover, there is a lack of studies among populations from the African region, most low- and lower-middle-income countries, and Indigenous communities. In conclusion, economic evaluations of preventive and MI dental caries procedures among children have increased over the last decade. Nonetheless, these are mostly cost-effectiveness analyses using clinically oriented outcomes, as opposed to patient-centred outcomes. We recommend collaboration with community partners while conducting economic evaluations for mutual capacity building.