Cavity Prevention is more Effective and Cheaper than Late Intervention

The Issue You Tackled

Early childhood caries (ECC) – tooth decay among children younger than 6 years – is highly prevalent and consequential in the United States, despite being highly preventable. Forty-four percent of 5-year-olds have cavity experience. ECC manifests frequently as pain and infection and disproportionately affects low income children, leading to avoidable expenditures by Medicaid and the Children’s Health Insurance Program.

The problem facing policy makers is selecting interventions that have greatest potential for reducing both disease and costs.

What You Actually Did

ECC modeling projects span five years and two states, Colorado and New York. These models helped policymakers in both states explore different preventive interventions to determine their potential impact on the percentage of children developing cavities, potential savings from reducing treatment costs, and ratios of treatment cost savings to preventive program costs. Preventive programs simulated included Community Water Fluoridation, fluoride varnish application, motivational interviewing of parents, tooth brushing encouragement, and preventive dental visits and combinations of these and other programs.

The Results

The Colorado model included all children aged 0-5. The New York model represented children covered by that state’s Medicaid program. The models helped policymakers see the alternative benefits of broad-based programs affecting all children (maximum reduction in cavities) vs. programs focused on children at the highest risk of developing ECC (highest return per program dollar invested).

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