Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>Paediatric dental care under general anaesthesia among preschool children in Western Australia is increasing and costly. This study assessed cost‐effectiveness of the atraumatic restorative treatment‐based (<jats:styled-content style="fixed-case">ART</jats:styled-content>‐based) approach against the standard care (<jats:styled-content style="fixed-case">SC</jats:styled-content>) approach to managing early childhood caries in a primary care setting based on a 1‐year pragmatic randomized controlled trial.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Cost‐effectiveness analysis, from the service provider perspective, was conducted. Outcomes include number of referral to specialists and dental treatments. One‐way and probabilistic sensitivity analyses were undertaken to test the robustness of the cost‐effectiveness estimates.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Six children in the <jats:styled-content style="fixed-case">ART</jats:styled-content>‐based group and 62 children in the <jats:styled-content style="fixed-case">SC</jats:styled-content> group (<jats:italic>n</jats:italic> = 127 each group) were referred for paediatric dental specialist care. Children in the <jats:styled-content style="fixed-case">ART</jats:styled-content>‐based group received more dental services than those allocated to the <jats:styled-content style="fixed-case">SC</jats:styled-content> group (mean = 3.8, <jats:styled-content style="fixed-case">SD</jats:styled-content> 2.0 and mean = 1.8, <jats:styled-content style="fixed-case">SD</jats:styled-content> 1.8, respectively, Wilcoxon rank‐sum test, <jats:italic>P</jats:italic> < 0.01). Total costs of the <jats:styled-content style="fixed-case">ART</jats:styled-content>‐based approach and the <jats:styled-content style="fixed-case">SC</jats:styled-content> group were $137 860 and $178 217, respectively. Based on probabilistic sensitivity analysis, $654 was saved per referral to specialist avoided and $36 was saved per additional dental treatment. The probability that the <jats:styled-content style="fixed-case">ART</jats:styled-content>‐based approach is cost‐saving was 63%. Specialist dental treatment fees had a big impact on the cost‐effectiveness estimates.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The <jats:styled-content style="fixed-case">ART</jats:styled-content>‐based approach appears to be a worthwhile intervention because it resulted in fewer referred cases and enabled more treatments to be provided with cost‐savings.</jats:p></jats:sec>