Health care savings from microbiological caries risk screening of toddlers: a cost estimation model

Objectives: Modeling new biomedical technologies and determining their expe cted cost is necessary before initiating formal clinical trials. This paper estimates an economic model for the potential cost impact of microbiologic al screening of toddlers for caries risk compared to the traditional method of managing pediatric caries. Methods: Potential cost savings were calcula ted based on screening test properties (sensitivity and specificity) derive d from a population of 1,180 children aged 1 to 3 years with a caries preva lence of 15 percent. An algorithm was then developed to allocate prevalent and anticipate incident caries, treatment effectiveness assumptions, and ex isting regional treatment costs. Results: The cost analysis model conservat ively predicts savings of 7.3 percent from screening and early intervention . Cumulative dental treatment costs for a child at age 4 years are $367.90 if the child has been screened and $396.70 otherwise. The model further pre dicts that cost savings increase significantly as caries prevalence increas es. Conclusions: Microbiologic risk assessment for pediatric caries may be an example of a preventive public health screening technique that results i n both clinical benefits and cost savings. If the model is validated by ran domized clinical trials, microbiologic screening could be used by pediatric primary care providers to identify toddlers who require early referral to dentists for further risk assessment and early caries management.