Is Non-invasive Management Of Dental Caries In Private Practice Cost-effective? A Randomized Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$325,136.00
Summary
Despite evidence to the contrary, dentists routinely fill decayed teeth that, managed preventively, would be likely to repair (arrest). The probable cost to society of this approach is enormous. Modeling indicates that each new dental filling is likely to cost an average of $1811 (US) over the life-cycle of a tooth. This figure includes re-treatment costs, and the increased likelihood of more expensive re-treatment in future, such as root canal treatment and tooth crowning. An examination of the ....Despite evidence to the contrary, dentists routinely fill decayed teeth that, managed preventively, would be likely to repair (arrest). The probable cost to society of this approach is enormous. Modeling indicates that each new dental filling is likely to cost an average of $1811 (US) over the life-cycle of a tooth. This figure includes re-treatment costs, and the increased likelihood of more expensive re-treatment in future, such as root canal treatment and tooth crowning. An examination of the societal costs involved is likely to reveal this amount to be an under-estimate; consider the costs borne by sectors outside health: days lost to work, lost productivity. Further, we should consider costs to families: travel time and costs, childcare, the opportunity cost of items forgone in order to pay for the dental treatment. Despite this, a recent systematic review of dental caries prevention concluded 'there is presently no proof, in published economic evaluations of the cost-effectiveness of caries-preventive measures'. The authors highlighted a lack of methodologically sound studies. This research will compare a targeted preventive program to standard care within private dental practices. Prior to an alternative approach being introduced, an assessment of effectiveness and cost-effectiveness is needed. It is through such assessment that the value of the comparator can be assessed and our precious health dollars saved. The radical surgical approach (filling) that evolved to deal with the caries problem is entrenched in both public and private institutions that teach and deliver dental care. The strategic element is to reorient the services provided by general practices towards to goal of delivering a substantial reduction in the need to drill teeth, while maximizing the opportunity for a non-invasive remineralization approach that has been successfully demonstrated in in-vitro, in-vivo, and in small scale clinical trials.Read moreRead less
Tooth Emergence And Oral Streptococci Colonisation: A Longitudinal Study Of Australian Twins
Funder
National Health and Medical Research Council
Funding Amount
$521,600.00
Summary
We plan to include over 500 Australian families of twins in this 5-year study and to collect records of tooth emergence, cheek cells for DNA analysis, dental plaque samples for microbiological analysis, as well as other information from questionnaires. Firstly, we want to learn how genetic and non-genetic factors influence the timing and sequence of emergence of primary (baby) teeth. Most children get their baby teeth between the ages of 6 months and 2.5 years, but sometimes they appear earlier, ....We plan to include over 500 Australian families of twins in this 5-year study and to collect records of tooth emergence, cheek cells for DNA analysis, dental plaque samples for microbiological analysis, as well as other information from questionnaires. Firstly, we want to learn how genetic and non-genetic factors influence the timing and sequence of emergence of primary (baby) teeth. Most children get their baby teeth between the ages of 6 months and 2.5 years, but sometimes they appear earlier, even at birth, and some children don't get all their baby teeth until about 4 years. By studying identical twins and non-identical twins we will be able to work out whether genetic factors are most important in determining this variation or whether other factors such as diet or illness also play a significant role. Secondly, we want to find out whether there is a relationship between the timing of emergence of the primary teeth and the growth of bacteria in the mouth that may lead to dental decay. It seems that the most likely source of the bacteria that can cause dental decay is a baby's mother and that children infected before three years of age are more likely to get dental decay subsequently. We will determine when decay-producing bacteria first appear in the mouth and check whether the same types of bacteria are present in twins and their mothers. This information will enable us to sort out whether the process that allows bacteria to become established around the teeth has a strong genetic basis or not. If we can gain a better understanding of how genetic and environmental factors influence dental development, we will be in a better position to manage individuals with altered tooth emergence that can lead to crowded teeth. Furthermore, if we can demonstrate a link between tooth emergence, growth of oral bacteria, and development of dental decay, we should be able to determine the most effective time to introduce preventive measures to control dental disease.Read moreRead less
Discovery Early Career Researcher Award - Grant ID: DE120101666
Funder
Australian Research Council
Funding Amount
$375,000.00
Summary
Endogenous bone regenerative technique to repair hard tissue defects in congenital craniofacial clefts. This project aims to develop an endogenous bone regenerative technique to repair the bony defects in congenital craniofacial clefts, through stimulating patients' latent self-repair mechanisms and reviving their innate capacity for regeneration. The novel technique would replace the existing and controversial surgical bone grafting method.
Characterization Of Casein Phosphopeptide Amorphous Calcium Fluoride Phosphate As A Remineralization System
Funder
National Health and Medical Research Council
Funding Amount
$493,514.00
Summary
Dental caries (tooth decay) remains a major public health problem in Australia with an economic burden in excess of $1 billion p.a. The overall aim of this project is the development of a novel remineralizing agent (casein phosphopeptide stabilized amorphous calcium fluoride phosphate) for the remineralization of early tooth decay lesions (white spot lesions). The project will involve the testing of the ability of the novel remineralization system to remineralize (repair) white spot lesions in v ....Dental caries (tooth decay) remains a major public health problem in Australia with an economic burden in excess of $1 billion p.a. The overall aim of this project is the development of a novel remineralizing agent (casein phosphopeptide stabilized amorphous calcium fluoride phosphate) for the remineralization of early tooth decay lesions (white spot lesions). The project will involve the testing of the ability of the novel remineralization system to remineralize (repair) white spot lesions in vitro and in situ. The project also involves the detailed characterization of the molecular interactions of the components of the remineralizing system using NMR spectroscopy and other techniques. It is anticipated that this project will result in the development of a system with substantialy superior properties for the non-invasive treatment (reversal) of white spot lesions and may ultimately lead to the development of a novel system for the treatment and prevention of tooth decay.Read moreRead less
Long-term Efficacy Of An Oral Health Promotion Program In The Prevention Of Early Childhood Caries.
Funder
National Health and Medical Research Council
Funding Amount
$165,664.00
Summary
The aim of the project is to test the long-term efficacy of oral health promotion program, the purpose of which is to lower the prevalence of tooth decay among young children. Tooth decay affects approximately 1 in 6 children by age of 3 years and 1 in 2 children by age of 5 years. The disease negatively influences all aspects of quality of life of child. Tooth decay is associated with infection, pain, and frequent hospitalisation. The proposed project is a follow-up of an randomised controlled ....The aim of the project is to test the long-term efficacy of oral health promotion program, the purpose of which is to lower the prevalence of tooth decay among young children. Tooth decay affects approximately 1 in 6 children by age of 3 years and 1 in 2 children by age of 5 years. The disease negatively influences all aspects of quality of life of child. Tooth decay is associated with infection, pain, and frequent hospitalisation. The proposed project is a follow-up of an randomised controlled trial (RCT), which started with enrolment of pregnant women. They were randomised into the test and control groups. Mothers in test group received 3 round of preventive oral health information in the form of anticipatory guidance, the first round at enrolment, the second and third at 6, 12 months of age of child respectively. The information was mailed to their home address. All children were examined at age of 20 months of age. The children in the test group had lower prevalence of tooth decay compared to children in control group, (test group 1,7%, control group 9.6%). While the oral health information was effective in preventing decay at 20 months, longer-term follow-up is highly desirable. Therefore, we plan to follow-up the oral health of the children at 5 - 6 years old. It is anticipated, that 75% mothers from the trial will be contactable and will continue with their participation in the study. A third comparative group of children at the same age will be drawn from database of the South Australian School Dental Services to check if the children in the trial are representative of all SA school children. All children will be examined by dentists or school dental therapists after they enter school. The prevalence of the tooth decay and its mangement will be examined and compared among children from test and control groups and children from community.Read moreRead less
Environmental, Socio-behavioural And Biological Predictors Of Early Childhood Caries: A Rural Birth Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$495,432.00
Summary
In Australia, up to 75% of children have dental decay at five years of age. It is substantially worse in rural parts of Australia, where fluoride is not added to the water supply. Also, the rate of caries increases as socioeconomic status decreases. This study aims to describe the natural history of dental caries from birth to 18 months. It will also examine the environment, behaviours and biology that these infants are exposed to. This data has never been collected before and will therefore pro ....In Australia, up to 75% of children have dental decay at five years of age. It is substantially worse in rural parts of Australia, where fluoride is not added to the water supply. Also, the rate of caries increases as socioeconomic status decreases. This study aims to describe the natural history of dental caries from birth to 18 months. It will also examine the environment, behaviours and biology that these infants are exposed to. This data has never been collected before and will therefore provide a unique contribution to our knowledge and understanding of the development of dental decay in young children. This data is crucial for the development of interventions to prevent dental decay and address health inequalities. The study will examine infants teeth as they come into their mouths and collect questionnaire and saliva data from parents and infants following birth at 1, 6, 12 and 18 months. It is a partnership between the maternal and child health nurses of the western rural areas of Victoria (Ballarat, Ararat, Stawell and Horsham) and a national team of child health, dental researchers and statisticians drawn from the School of Health and Social Development at Deakin University, the Murdoch Children's Research Institute and The Royal Children's Hospital's Department of Paediatric Dentistry, The University of Melbourne, The University of Western Australia, Griffith University and the Queensland Government. The proposed study will make a substantial contribution to the understanding of early childhood caries by providing unique data on its natural history, the relationship between caries and risk and protective factors and the relative contribution of these factors to dental decay. Additionaly, it will include the latest measurement developments for quantifying microflora species and clinical caries outcomes. The comprehensiveness of this approach has been called for internationally, but has not yet been attempted.Read moreRead less