The Monitor Practice Programme: is non-invasive management of dental caries in private practice cost-effective?

Aust Dent J. 2011 Mar;56(1):48-55. doi: 10.1111/j.1834-7819.2010.01286.x. Epub 2011 Jan 10.


Background: The objective of this research was to assess the efficacy and cost-effectiveness of a non-invasive approach to dental caries management in private dental practice.

Methods: Private dental practices from a variety of locations in New South Wales were randomly allocated to either non-invasive management of caries, or continue with usual care. Patients were followed for three years and caries incidence assessed. A patient-level decision analytic model was constructed to assess the cost-effectiveness of the intervention at two years, three years, and hypothetical lifetime.

Results: Twenty-two dental practices and 920 patients were recruited. Within the clinical trial there was a significant difference in caries increment favouring non-invasive therapy at both two and three years. Efficacy was independent of age, gender, medical concerns, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices, in a variety of locations both urban and rural. Cost per DMFT avoided estimate was A$1287.07 (two years), A$1148.91 (three years) decreasing to A$702.52 in (medium) and A$545.93 (high) risk patients (three years).

Conclusions: A joint preventive and non-invasive therapeutic approach appears to be cost-effective in patients at medium and high risk of developing dental caries when compared to the standard care provided by private dental practice.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cariostatic Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis
  • DMF Index
  • Decision Support Techniques
  • Dental Care / economics*
  • Dental Caries / economics
  • Dental Caries / prevention & control*
  • Dental Caries Susceptibility
  • Female
  • Fluorides / therapeutic use
  • Follow-Up Studies
  • Humans
  • Insurance, Dental / economics
  • Male
  • Middle Aged
  • New South Wales
  • Private Practice / economics*
  • Rural Health Services / economics
  • Sex Factors
  • Treatment Outcome
  • Urban Health Services / economics
  • Young Adult


  • Cariostatic Agents
  • Fluorides