Managing root caries with silver diamine fluoride, sodium fluoride and direct restorations: A cost-effectiveness analysis

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dc.check.date2026-09-13en
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisheren
dc.contributor.authorHu, Shijiaen
dc.contributor.authorHong, Catherine Hsu Lingen
dc.contributor.authorGao, Xiaolien
dc.contributor.authorWee, Hwee-Linen
dc.contributor.authorWang, Yien
dc.contributor.authorLai, Bien Wen Puien
dc.contributor.authorHo, Shenna Yu-Enen
dc.contributor.authorAllen, Patrick Finbarren
dc.contributor.authorTan, Sharon Hui Xuanen
dc.contributor.funderNational Medical Research Councilen
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2025-10-16T14:58:26Z
dc.date.available2025-10-16T14:58:26Z
dc.date.issued2025-09-13en
dc.description.abstractObjective: To assess the cost-effectiveness of silver diamine fluoride (SDF) relative to sodium fluoride (NaF) and traditional resin-modified glass ionomer cements (RMGIC) restorations for the management of root caries in older adults aged 60 and above. Methods: A Markov model design was chosen and two models were constructed: 1) Clinic-based model - with access to dental facility that allows for placement of traditional restorations, 2) Community-based model - without access to dental facility due to mobility, lack of executive function, or financial barriers. Modelling was done over a 10-year time horizon with a cycle length of one year. Data on transition probabilities and relative risks were obtained from published literature for the base case. Outcomes of interest were incremental cost per incremental caries-controlled year and incremental cost per incremental extraction-free year. Probabilistic sensitivity analyses were conducted to account for uncertainty in the base case. Results: In the clinic-based model, both SDF and NaF were dominated by traditional RMGIC restorations, which had lower cost, and higher number of caries-controlled and extraction-free years, with a 90% probability of being cost-effective. In the community-based model, NaF was dominated by SDF, which incurred lower cost and resulted in a higher number of caries-controlled and extraction-free years, with almost 100% probability of being cost-effective. Conclusions: Traditional RMGIC restoration was the most cost-effective option for managing root caries when full dental facility is available. In situations where treatment is provided in a community setting, SDF was more cost-effective than NaF. CLINICAL SIGNIFICANCE: Based on limited clinical studies and within the Singapore oral health system, traditional RMGIC restoration was most cost-effective in clinical settings for managing root caries, while SDF was most cost-effective in community settings.en
dc.description.sponsorshipNational Medical Research Council Grant (MOH-000741): Health Services Research New Investigator Grant (HNIG20nov-0006)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid106093en
dc.identifier.citationHu, S., Hong, C. H. L., Gao, X., Wee, H. L., Wang, Y., Lai, B. W. P., Ho, S. Y. E., Allen, P. F. and Tan, S. H. X. (2025) 'Managing root caries with silver diamine fluoride, sodium fluoride and direct restorations: A cost-effectiveness analysis', Journal of Dentistry, 162, p.106093 (7pp). https://doi.org/10.1016/j.jdent.2025.106093en
dc.identifier.doi10.1016/j.jdent.2025.106093en
dc.identifier.endpage7en
dc.identifier.issn0300-5712en
dc.identifier.journaltitleJournal of Dentistryen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/18054
dc.identifier.volume162en
dc.language.isoenen
dc.publisherElsevier Ltd.en
dc.relation.ispartofJournal of Dentistryen
dc.rights© 2025, Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectCost-effectiveness analysisen
dc.subjectFluorideen
dc.subjectGeriatric dentistryen
dc.subjectRoot cariesen
dc.subjectSilver diamine fluorideen
dc.subject~Cork University Dental School and Hospital - Journal Articles~en
dc.titleManaging root caries with silver diamine fluoride, sodium fluoride and direct restorations: A cost-effectiveness analysisen
dc.typeArticle (peer-reviewed)en
dc.typejournal-articleen
oaire.citation.volume162en
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