Abstract
Prevention and health promotion are considered important strategies to control oral diseases. Dental caries is preventable disease and remains the most common chronic disease that affects mainly low income children and still considered the main cause of tooth loss in adulthood in Brazil. The aim of this study is to present a System Dynamics model (SDM) specifically developed with the Stella Architect software to estimate the cost and clinical hours required to control the evolution of dental caries in preschool children in Maringá, Brazil. Two main strategies to control caries were considered in the model: the application of fluoride varnish on teeth presenting white spots, and the use of Atraumatic Restorative Treatment (ART) in cavitated carious lesions without pulp involvement. The parameters used in the model were: number of people covered by a local oral health team = 4,000; number of children up to 5 years = 7% of the population; children's decayed, missing, filled teeth (dmft) index = 2.4; time/cost of 4 applications of fluoride varnish = 5 minutes/US$ 0.716; and time/cost of each ART restoration = 15 minutes/US$ 1.475. The SDM generated an estimated total cost of US$698.00, and a total of 112 clinical hours to treat the population in question. The use of the SDM presented here has the potential to assist decision making by measuring the material and human resources required to prevent and control dental caries at an early age.
Highlights
IntroductionEspecially during childhood, can be a powerful ally to prevent chronic diseases, such as dental caries, which are triggered by the high consumption of free sugars present in their diet.[1] The acquisition of healthy habits promoted by oral health education, in association with programs to control dental caries evolution, can prevent future tooth loss during adulthood.[2] In Brazil, for instance, while children up to 5 years present a mean decayed, missing, filled teeth (dmft) index of 2.43, people aged between 65 and 74 years show a mean DMFT of 27.53, with high prevalence of tooth loss.[3] In the 2010 Global Burden of Disease study, among 291 evaluated diseases, untreated caries in permanent teeth was considered the most prevalent condition
Oral health education, especially during childhood, can be a powerful ally to prevent chronic diseases, such as dental caries, which are triggered by the high consumption of free sugars present in their diet.[1]
The objective of the present study is to present a System Dynamics model (SDM) developed to estimate the cost and clinical hours required to control the development of dental caries lesions in preschool children in Brazil
Summary
Especially during childhood, can be a powerful ally to prevent chronic diseases, such as dental caries, which are triggered by the high consumption of free sugars present in their diet.[1] The acquisition of healthy habits promoted by oral health education, in association with programs to control dental caries evolution, can prevent future tooth loss during adulthood.[2] In Brazil, for instance, while children up to 5 years present a mean decayed, missing, filled teeth (dmft) index of 2.43, people aged between 65 and 74 years show a mean DMFT of 27.53, with high prevalence of tooth loss.[3] In the 2010 Global Burden of Disease study, among 291 evaluated diseases, untreated caries in permanent teeth was considered the most prevalent condition. Because public health interventions tend to operate in dynamically complex systems, decision making processes require tools that can provide support to public policy planning, estimating future demands and resources. The objective of the present study is to present a System Dynamics model (SDM) developed to estimate the cost and clinical hours required to control the development of dental caries lesions in preschool children in Brazil
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