Comparative costs and cost-effectiveness of materials and approaches in the treatment and prevention of dental caries in a mixed dentition: Community trials in Wuhan, China and Paranoá, Brazil

This PhD thesis investigates and compares the costs and cost-effectiveness dental caries prevention and treatment efforts initiated in populations of 6-to 8-year-old children in China and Brazil. The analyses take place within the framework of government oral health programs designed for delivery through the public-school system in countries where oral health services are still in the process of being structured and articulated. Its findings are meant to enhance the capacity of primary oral health decision makers and practitioners to improve prevention and intervention programs through expanding the information pool regarding costing components that go into the delivery of those programs. The challenges identified in the development and implementation of the costing and cost-effectiveness studies and in the interpretation and extrapolation of the findings from the study populations to the general population helped to highlight areas of future research needs. These include cost-effectiveness research on: 1) Comparisons of ART/HVGIC and composite resin sealants; 2) ART/HVGIC restorations for the 6-8 age group seen in these studies, as well as for younger and older children; and, 3) supervised toothbrushing of cavitated dentine carious lesions to explore a variety of potential models, including supervision in the schools by teachers and family members as well as, depending on the organization of the national oral health system, community dental health workers.