Cost-Utility Analysis of Treatments for Early Childhood Caries in Remote Aboriginal Communities

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dc.contributor.authorTonmukayakul, U.
dc.contributor.authorKularatna, S.
dc.contributor.authorAtkinson, D.
dc.contributor.authorJamieson, L.
dc.contributor.authorArrow, P.
dc.date.issued2025
dc.descriptionOnlinePubl. Available online 16 August 2025
dc.description.abstractIntroduction: Early childhood caries is a significant problem affecting Aboriginal preschoolers in remote communities who lack access to dental services. A trial was conducted to assess the benefits of atraumatic restorative treatment combined with the Hall technique (ART-HT) versus usual care for managing early childhood caries in this population. Objectives: This trial-based costutility analysis evaluates costs and quality-adjusted life-years (QALYs) of ART-HT compared with usual care within a 1-y time frame. Methods: A decision-analytic model simulated the costs and QALYs for 2 scenarios: trial service delivery and minimum ART-HT delivery. The incremental cost per QALY gain ratio (ICER) was calculated for each scenario. QALY were estimated using the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) and adjusted for baseline. Probabilistic sensitivity analyses were conducted to assess the robustness of the base-case results. Cost-effectiveness acceptability curves were generated to determine the likelihood of ART-HT being costeffective at various willingness-to-pay thresholds. All costs are presented in Australian dollars for 2021. Results: Children receiving ART-HT had slightly higher QALYs than those receiving usual care did (0.85 vs. 0.83). The base-case analysis showed an average ICER of $2,013/ QALY gained (95% uncertainty interval −$45,246 to $21,676). In the sensitivity analysis, the average ICER was $2,573/QALY gained (95% uncertainty interval −$43,658 to $23,352). ART-HT had an 85% and 81% chance of being cost-effective at a $15,000/QALY gained threshold in the base-case and alternative scenario, respectively. Conclusion: ART-HT showed potential cost-effectiveness compared with usual care within the observed period. While QALY gains were modest, ART-HT may offer a valuable strategy to improve service access for Aboriginal children in remote communities.
dc.description.statementofresponsibilityU. Tonmukayakul, S. Kularatna, D. Atkinson, L. Jamieson, and P. Arrow
dc.identifier.citationJDR Clinical and Translational Research, 2025; 1-9
dc.identifier.doi10.1177/23800844251346743
dc.identifier.issn2380-0844
dc.identifier.issn2380-0852
dc.identifier.orcidJamieson, L. [0000-0001-9839-9280]
dc.identifier.orcidArrow, P. [0000-0003-1647-2128]
dc.identifier.urihttps://hdl.handle.net/2440/147927
dc.language.isoen
dc.publisherSAGE Publications
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/11211982
dc.rights© International Association for Dental, Oral, and Craniofacial Research and American Association for Dental, Oral, and Craniofacial Research 2025
dc.source.urihttps://doi.org/10.1177/23800844251346743
dc.subjectHall technique
dc.subjectIndigenous health
dc.subjectatraumatic restorative treatment
dc.subjectdental caries
dc.subjecteconomic evaluation
dc.subjectquality-adjusted life-years
dc.titleCost-Utility Analysis of Treatments for Early Childhood Caries in Remote Aboriginal Communities
dc.typeJournal article
pubs.publication-statusPublished

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