Comparison of the oral health status and costs of the provision of dental care in ten high-income countries

Abstract

Objective: Comparison of different types of oral health systems in relation to outcome and cost figures with the aim of evaluating system efficiency by using quantifiable results. Method: A composite indicator -the Dental Health Index -was used as the overall value for measuring a population´s dental status. The DHI is linked to the total dental costs as a percentage of the gross domestic product (GDP), in order to create an index of system efficiency, which subsequently facilitates comparisons with other high-income countries. Results: In general, good oral health can be achieved in each of the different types of advanced dental care. However, the national health system of Sweden (SE) and the social security system of Korea (KR) performed better than the systems of all other countries. Superior in terms of system efficiency is the national health systems of the United Kingdom (UK) and Sweden (SE) and a social security model (KR). Overall, the Swedish system can be considered as best-practice-model for dental care. Conclusion: Across the systems, models that foster a preventive and tooth-retaining approach -also for their adult population – make faster and better progress in improving oral health status, are more cost-effective and demonstrate superior system efficiency. A range of 5% to 6% of GDP turns out to be a good benchmark for cost-efficacy in countries with elevated oral health status. Moreover, countries that implement an active oral health policy perform better.