Cost-effectiveness of personalised plaque control for managing the gingival manifestations of oral lichen planus: a randomised controlled study

Aim: To undertake cost-effectiveness and cost benefit analyses of an intervention to improve oral health in patients presenting with the gingival manifestations of oral lichen planus (OLP). Materials and Methods: 82 Patients were recruited to a 20-week randomised controlled trial. The intervention was personalised plaque control comprising powered tooth brushing and interdental cleaning advice. The primary outcome measure was the oral health impact profile (OHIP) with secondary outcomes of pain, plaque index, mucosal disease score and cost-effectiveness. Private cost data and stated willingness to pay (WTP) values for treatment were obtained from intervention patients at 20 weeks. Results: 81% of intervention patients showed improvement in both plaque index and mucosal disease score at 20 weeks compared to 30% of controls that continued with their usual plaque control regimen. All intervention group patients stated a positive WTP value. The mean net value of the treatment was £172 compared to the incremental cost of the treatment estimated at £122.75. The cost-effectiveness analysis resulted in an incremental cost-effectiveness ratio of £13 per OHIP point. Conclusions: The tailored plaque control programme was more effective than control in treating the gingival manifestations of oral lichen planus. The programme is cost effective for modest values placed on a point on the OHIP scale and patients generally valued the treatment in excess of the cost.