Are Dentists Drilling Your Teeth Unnecessarily?23 Jun 2010
Despite over 30 years of research implying the contrary, dentists persist drilling and filling tooth surfaces which have the capacity to heal, leading to repeated and costly dental treatment.
The objective of this randomized controlled trial, conducted by the University of Sydney Dental School, was to review the efficacy and cost-effectiveness of a non-invasive approach to the management of dental caries within a variety of private dental practices in Australia.
The non-invasive program was effective in reducing the incidence of new and recurrent decay over the 3 years of the study by more than 40 percent. These results were independent of age, gender, medical status, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices. Further, it appears in patients categorized at medium to high risk of developing dental decay, that the program was reasonably cost-effective when compared to existing dental care practice.
The prevention of caries has been, and still is, a major goal for the dental profession. A recent study, "Modeling the long-term cost-effectiveness of the Caries Management System in an Australian population" published in Value in Health, highlights the disparity between routine dental clinical practice and a model of care which is evidence-based in terms of diagnosis and preventive intervention.
Says study co-author Associate Professor Wendell Evans (Head - Community Oral Health and Epidemiology - University of Sydney): "Unfortunately dental care has moved towards a more interventionist model - the current payment rebate and remuneration process is weighted towards rewarding fillings performed, crowns fitted. This newly adopted system for early decay diagnosis has opened opportunities for action to prevent cavities. The shift in resources towards more expensive and cosmetic procedures, while understandable, is creating a resource and access issue that will require the collaboration of the profession, patients, dental funds and researchers - we see this study very much as a first step towards defining and potentially addressing the problem ".
This will be discussed in a future issue of Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 5,000 clinicians, decision-makers, and researchers worldwide.