Managing High-Risk Root Caries with Silver Diamine Fluoride Application: A Markov Simulation Study.

IF 2.5 Q2 ECONOMICS

Journal of Health Economics and Outcomes Research Pub Date : 2026-05-14 eCollection Date: 2026-01-01 DOI:10.36469/001c.160210

Young S Kim, Ji W Yoo, Maryam Tabrizi, Jae-In Ryu, Yonsu Kim, Maria Teresa Chong, Dong-Hun Han, Jong Ho Won, Yoohwan Kim, Iulia Ioanitoaia-Chaudhry, Mark J Rosenberg, Marcia Loo, Claire S Lee, Anderson Penna

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引用次数: 0

Abstract

Background: Dental caries are common oral health conditions among Medicaid beneficiaries. Silver diamine fluoride (SDF) has been applied to manage dental caries.

Objectives: To evaluate the cost-effectiveness of SDF application for managing high-risk root caries within the context of Medicaid, a Markov simulation model was adopted from a healthcare system perspective.

Methods: A 45-year-old subject with 21 residual teeth was simulated for 19 years. Twice-yearly 38% SDF application on the tooth surface at risk for caries was compared with 5% sodium fluoride (NaF) varnish in terms of effectiveness and cost. Tooth-years free of extraction were set as the effect.

Results: Compared with 5% NaF varnish, 38% SDF application was cost-effective, with a difference of 6.34 extraction-free tooth-years and an additional cost of $7798 (i n c r e m e n t a l c o s t - o f - e f f e c t i v e n e s s r a t i o,$ 1229 per extraction-free tooth-year gained; incremental net monetary benefit, $309 355). One-way sensitivity analyses on SDF and NaF costs confirmed cost-effectiveness of SDF application over NaF varnish.

Conclusions: An integrated orosystemic care model is underscored to disseminate the benefits of SDF application as the Medicaid payment system shifts from fee-for-service to managed care. Semiannual 38% SDF application might reduce and delay tooth extraction due to root caries in statewide dental provider shortage areas, particularly "dental deserts," where Medicaid-accepting dentists are not available.

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应用氟化二胺银管理高危牙根龋：马尔科夫模拟研究。

背景：龋齿是医疗补助受益人中常见的口腔健康状况。二胺氟化银（SDF）已被应用于治疗龋齿。目的：为了评估在医疗补助的背景下应用SDF管理高风险牙根龋的成本效益，从医疗保健系统的角度采用了马尔可夫模拟模型。方法：对一名45岁、21颗残牙的受试者进行19年模拟。在有龋齿风险的牙齿表面每年两次使用38%的SDF与5%氟化钠（NaF）清漆在效果和成本方面进行了比较。以无拔牙牙龄作为影响因素。结果：与5%的NaF清漆相比，38%的SDF应用具有成本效益，差异为6.34个无牙年，额外成本为7798美元（1个月的无牙年，1个月的无牙年，1个月的无牙年，1个月的无牙年，1个月的无牙年，1个月的无牙年，1个月的无牙年，1个月的无牙年，1个月的无牙年，增加的净货币效益为309355美元）。对SDF和NaF成本的单向敏感性分析证实了SDF应用于NaF清漆的成本效益。结论：在医疗补助支付系统从按服务收费向管理式医疗转变的过程中，强调了一种综合的系统护理模式，以传播SDF应用的好处。半年度38%的SDF申请可能会减少和延迟因牙根龋齿而导致的拔牙，特别是在全州牙科提供者短缺的地区，特别是“牙科沙漠”，那里没有接受医疗补助的牙医。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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