[Effectiveness and cost-effectiveness of risk-based topical fluoride intervention on early childhood caries in Jiangnan District, Nanning City].

OBJECTIVES

This study aims to evaluate the clinical effectiveness and cost-effectiveness of personalized topical fluoride intervention guided by the modified caries-risk assessment tool for preschool children (PSC-MCAT) for preschool children in Jiangnan District of Nanning City and to provide evidence to support the implementation of community-based graded oral health interventions for preschooler children.

METHODS

A total of 198 three-year-old children from Jiangnan District, Nanning City, were recruited and randomly assigned to a test or control group. Baseline data were collected through questionnaires and oral examinations. The test group received personalized topical fluoride treatments based on caries risk levels determined using the PSC-MCAT, whereas the control group received standard fluoride varnish application every six months. After 1.5 years of follow-up, the incidence of new caries and changes in mean dmft increment were analyzed. Cost-effectiveness analysis was conducted to assess economic benefits, and sensitivity analysis was performed to evaluate result stability.

RESULTS

After 1.5 years, the test group demonstrated significantly lower caries incidence (50.9%) and △dmft (1.42±1.90) compared with the control group (68.9%, 2.74±2.92) (P<0.05). Cost-effectiveness analysis indicated that the incremental cost to prevent one new case of caries in the test group was 559.66 yuan, which was lower than the willingness-to-pay threshold (626.77 yuan). The cost per prevented caries lesion was 153.80 yuan, which was lower than the direct treatment cost of 200.5 yuan per lesion. Sensitivity analysis indicated a 99.8% probability that the intervention is cost-effective at a willingness-to-pay of 626.77 yuan per person.

CONCLUSIONS

The PSC-MCAT tool is effective and cost-effective for caries risk assessment and may serve as a practical framework for caries prevention.