J Clin Pediatr Dent. 2020 Dec 1;44(6):400-406. doi: 10.17796/1053-4625-44.6.2.
The objective was to compare dental visits, procedures, and expenditures in children with newly diagnosed caries.
A retrospective chart review was conducted in a two dentist private practice in North Carolina. Demographic data, health status, and dental treatment data was collected. Analysis relied upon nearest neighbor matching to estimate the average treatment effects of silver diamine fluoride (SDF) by comparing children who received SDF to children who did not receive SDF (n=104 matches).
After matching on age, gender, race, insurance status, dental cooperation, and dmft, the SDF group had significantly more dental visits (average treatment effect on treated (ATET)=1.08), fewer restorations (ATET=2.37), and fewer restorative and overall treatment expenditures (ATET=$402 and $292, respectively) than the non-SDF group. The SDF group more frequently received treatment under general anesthesia (26% vs 7%), so this group was excluded in secondary analysis. Among children who did not receive general anesthesia, the SDF group had significantly more dental visits (ATET=.66), fewer restorations (ATET=2.74), and fewer restorative and overall treatment expenditures (ATET=$566 and $515, respectively) than the non-SDF group.
SDF can offer cost savings when used as an adjunct to, rather than a complete replacement for, restorative treatment in young children.
本研究旨在比较新诊断龋病儿童的就诊次数、治疗程序和支出。
本研究对北卡罗来纳州的两家私人牙医诊所进行了回顾性图表审查。收集了人口统计学数据、健康状况和牙科治疗数据。分析依赖于最近邻匹配，通过比较接受银胺氟化物（SDF）治疗的儿童和未接受 SDF 治疗的儿童来估计 SDF 的平均治疗效果（n=104 对）。
在匹配年龄、性别、种族、保险状况、牙科合作和 dmft 后，SDF 组的就诊次数明显更多（治疗的平均处理效果（ATET）=1.08），修复体更少（ATET=2.37），修复和整体治疗支出也更少（ATET=$402 和 $292）。SDF 组更频繁地接受全身麻醉下的治疗（26% vs 7%），因此在二次分析中排除了该组。在未接受全身麻醉的儿童中，SDF 组的就诊次数明显更多（ATET=.66），修复体更少（ATET=2.74），修复和整体治疗支出也更少（ATET=$566 和 $515）。
SDF 作为年轻儿童修复治疗的辅助手段而不是完全替代手段，可以节省成本。
