Direct and indirect costs of dental trauma in Sweden: a 2-year prospectivestudy of children and adolescents

Objectives: To study total costs, including direct costs (health care servi ce. loss of personal property, medicine and transport) and indirect costs ( loss of production or leisure) of dental trauma to children and adolescents with special reference to predictors. Methods: The study was based on a ra ndom sample of 192 children and adolescents with a dental trauma reported t o an insurance company and prospectively followed up by telephone interview s over a period of 2 years. Results: On average, health care service costs represented 2955 SEK (SD=3818) and total costs 4569 SEK (SD=3053) for denta l trauma to permanent teeth, and 837 SEK (SD=898) and 1746 SEK (SD=1183) fo r trauma to primary teeth. The most extensive type of indirect cost was los s of production or leisure, which averaged 1286 SEK (SD=1830) for injuries to permanent teeth and 699 SEK (SD=1239) for injuries to primary teeth. Mul tiple regression analysis of demographic and dental injury variables showed that complicated trauma was of special importance to costs for permanent a nd primary teeth injuries. The average relative increase in total costs to patients and companions for complicated injury to permanent teeth tvas 140% (95% confidence interval [CI], 66-248%) for patients and 132% (95% CI, 54- 249%) for companions. Lack of access to a dental clinic near the place of r esidence could increase the average total costs of injuries to permanent te eth by 91% for companions (95% CI, 20-204%) and for primary teeth by 134% ( 95% CI, 38-296%). Conclusions: Dental traumas result in both direct and ind irect costs, with a predominance of direct costs. The direct costs primaril y depend on degree of severity, while indirect costs are mostly due to comp romised access to health care service. Traumas to permanent teeth are espec ially costly and, due to additional maintenance, the care may continue for several years. This study has drawn attention to the significant implicatio ns of dental trauma to patient and companion, a new area where further stud ies are warranted.