Oral HealthDeakin Health Economics
The Economics of oral health research stream at Deakin Health Economics aims to provide high quality evidence to demonstrate economic benefits of preventative models of care that utilise an all-of-team approach, including a broader health workforce.
The economics of oral health are poorly investigated, despite the far reaching prevention and treatment issues involved. Too few recognise that poor oral health is linked with systemic chronic disease and that it impacts significantly on individuals, the healthcare system and society. Current government funding for dental services is based on clinical output measures that promote surgical management of disease rather than the biological management and prevention of the disease itself.
This stream was established in January 2016 and, to date, we have developed national and international partners and collaborations across oral health services/programs, universities, the oral health industry, professional associations and government departments. We have established and lead the Disability and Oral Health Collaboration (DOHC) and the Pharmacy and Oral Health Alliance (PharOH). We are involved in a series of projects that include economic appraisal of dental caries management; and investigation of efficient dental workforce models, multidisciplinary integrated models of care, and oral health care for individuals with chronic health conditions.
The interventions we evaluate range from prevention to treatment of oral diseases across the life stages and multifaceted settings. We work with our research collaborators to ensure that all the trial-based projects we’re involved in have robust and practical economic evaluation techniques embedded within the study designs. Examples of the trial-based economic evaluation are the economic appraisal of teledentistry in age care facilities, and cost-effectiveness analysis of atraumatic restorative treatment in young children. We also specialise in using economic modelling techniques to evaluate the cost-effectiveness of interventions. The modelling approach is used when trial-based economic evaluation is not feasible, for example, assessing health benefits of reducing consumption of sugar in Australia, and cost-effectiveness of biannual application of fluoride.
Efficient Oral Health Care Provision Research
We embark on research that aims to improve the efficiency of oral health care provision. Research we have conducted includes:
- exploration of different workforce ratios in public dental services that could potentially save money and better utilise capacity of oral health professionals
- capacity building of oral health personnel in managing dental caries in primary teeth
- identification of the enablers and barriers to the implementation of evidence-based dental practice within public settings
- revalidation of a school-based dental check-up program
- evaluation of outreach dental services for young children
Integrated Care Research
We have initiated and worked with non-dental health professionals to improve care for population with systemic chronic conditions and high risk to oral health diseases. Programs include:
- development of a shared responsibility between general practitioners, primary care nurses and oral health professionals to address the linkage between diabetes and gum health
- education program for community pharmacists on dry mouth management
- improving oral health and quality of life for people with Parkinson’s disease
- dental health for people with intellectual disability
Evidence-based Oral Health Disease Studies
Brief examples of our more recent work include:
TM Nguyen, U Tonmukayakul, E Warren, S Cartwright, D Liew. A Markov cost-effective analysis of biannual fluoride varnish for preventing dental caries in permanent teeth over a 70-year time horizon. Health Promotion Journal of Australia. pp: 1– 7. 2019. doi:10.1002/hpja.2832019
U Tonmukayakul, P Arrow. Cost-effectiveness of atraumatic restorative treatment-based approach to managing early childhood caries. Community Dentistry and Oral Epidemiology, 2017. vol.45, no.1, pp. 92-100, doi: 10/1111/cdoe.12265
Efficient oral health care provision:
TM Nguyen, U Tonmukayakul, H Calache. A dental workforce strategy to make Australian public dental services more efficient, Human Resources for Health, 2019. vol.17, pp. 1-9, doi: 10.1186/s12960-019-0370-8
R Martin, P Lau, H Calache, E Boyce, M Gussy, J Furler, I Darby, M Chen, A Tran. Diabetes and oral health (DiabOH): a developing model of integrated care. International Journal of Integrated Care, 2019. Conference Abstract 19th International Conference on Integrated Care, San Sebastian, 1-3 April 2019
Evidence-based oral health:
M Gussy, G Mnatzaganian, S Dashper, L Carpenter, H Calache. Identifying predictors of early childhood caries among Australian children using sequential modelling: Findings from the VicGen birth cohort study. Journal of Dentistry. 2020. vol.93: 103276, doi: 10.1016/j.jdent.2020.103276