A RETROSPECTIVE ANALYSIS OF THE COSTS ASSOCIATED WITH THE TREATMENT OF NURSING CARIES IN A REMOTE CANADIAN ABORIGINAL PRESCHOOL POPULATION

Nursing caries is a specific form of rampant dental caries affecting t he majority of preschool aboriginal children who live in the Province of Manitoba, Canada. Since the majority of these individuals live in r emote regions of the province access to dental treatment is difficult, resulting in long delays in the provision of treatment and, most like ly, significant morbidity associated with dental pain and oral infecti on. Travel to distant centres for treatment under general anesthesia b y pediatric dentists has become the usual method by which treatment is provided to the majority of affected children. We believed that this was an expensive method of providing these necessary services and our purpose was to document all costs associated with the treatment of nur sing caries in this population. We analyzed the records of 884 childre n who were treated for nursing caries between 1980 and 1988 in Manitob a and collected data for costs in the following categories: travel, lo dging, medical, dental, hospital and nursing. Our results show that th e remote band groups had significantly higher costs (P < 0.001) than g roups which were located closer to treatment centres. The costs which accounted primarily for this significant difference were travel and me dical costs associated with hospitalization and the administration of general anesthesia. Our results support the need for the redeployment of resources on the basis of regional need and the development of comm unity-based preventive programs and treatment programs which will sign ificantly reduce the incidence of nursing caries in preschool Canadian aboriginal children.