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Cost Effectiveness of Dental Hygienists

Use of dental hygienists and returns to scale in child dental care in Norway

Wang NJ. Institute of Community Dentistry, Dental Faculty of Oslo, Norway.

The purpose of this study was to investigate, in the provision of dental care for children, technically and economically efficient combinations of dentists and dental hygienists and to study returns to scale by analyzing production functions. Data from 137 dental health clinics were analyzed. Output was registered as the number of 3-18-yr-old children to whom the clinic delivered complete dental care. Resource input was registered as hours spent by dentists, dental hygienists and dental assistants to deliver care to the children. The average clinic that employed dental hygienists used one hygienist hour per three dentist hours for child dental care. It would save dentist time, but not costs, to extent the use of hygienists. Increased use of dental hygienists might be economically efficient if the work distribution between the personnel groups were changed, for example, by delegating more examinations and preventive care to hygienists. There were technical opportunities for further substitution of dental hygienists for dentists both by introducing dental hygienists in the clinics that only used dentists in child dental care and by extending use of hygienists in clinics that already employed hygienists. This study found no productivity gain from centralizing treatment of children in large dental clinics.

Community Dent Oral Epidemiol. 1994 Dec;22(6):409-14.

PMID: 7882654 [PubMed - indexed for MEDLINE]

Cost Effectiveness of Dental Exam Frequency

Extending recall intervals-effect on resource consumption and dental health

Wang N, Marstrander P, Holst D, Ovrum L, Dahle T

Institute of Community Dentistry, Dental Faculty, Oslo, Norway.

The dental health of children has improved in recent years. This has stimulated more flexible planning and implementation of public dental care programs. The aim of the study was to compare time required for dental care and changes in dental health over a 2-yr period for patients examined and treated every 12 months and patients examined and treated every 24 months. The material comprised 185 children aged 3, 16 and 18 yr. Children with high caries prevalence were not included in the material. Time used for examination and treatment and dental health parameters were recorded. The data were analyzed using multiple linear regression analysis. Mean time used for examinations and mean total time used by the dental health service over the 2-yr period were significantly less for patients examined every 24 months than for patients examined every 12 months, while the treatment times did not differ between the groups. The longer recall interval was associated with greater DMFS increment but this was not statistically significant. The study indicates that the dental health service in Norway could save resources, i.e. increase the productivity in the short term by extending the intervals between examinations.

Community Dent Oral Epidemiol 1992 Jun;20(3):122-4

PMID: 1623701, UI: 92323884