Economic implications of evidence-based caries prevention in pediatric dental practice: a model-based approach.

OBJECTIVES This paper presents an economic model which can be used to assess the potential implications of evidence-based caries prevention in pediatric dental practice. METHODS Assessment of the evidence indicated that most children in the United States were likely to experience dental caries, though the severity of the disease would be minimal in most of them. Based on the evidence, it was concluded that annual recall examination and topical fluoride application would suffice as the norm for caries prevention. A model was developed to estimate the extent and cost of caries prevention in a traditional and an evidence-based pediatric dental practice. RESULTS The model showed that evidence-based caries prevention resulted in a one-third decline in the number of recall examination visits provided, while the ensuing patient revenues from recall appointments declined by two-thirds in a calendar year. CONCLUSIONS Evidence-based caries prevention will likely result in a significant decline in preventive services revenues and create additional capacity in pediatric dental practices. This economic impact will likely be absorbed by the current undersupply of pediatric dentists and by the reformulation of practice revenue streams.