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Direct and indirect costs of dental trauma in Sweden: a 2-year prospective study of children and adolescents
Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
2001 (English)In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, Vol. 29, no 2, 150-160 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To study total costs, including direct costs (health care service, loss of personal property, medicine and transport) and indirect costs (loss of production or leisure) of dental trauma to children and adolescents with special reference to predictors.

METHODS: The study was based on a random sample of 192 children and adolescents with a dental trauma reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years.

RESULTS: On average, health care service costs represented 2,955 SEK (SD=3,818) and total costs 4,569 SEK (SD=3,053) for dental trauma to permanent teeth, and 837 SEK (SD=898) and 1,746 SEK (SD=1,183) for trauma to primary teeth. The most extensive type of indirect cost was loss of production or leisure, which averaged 1,286 SEK (SD=1,830) for injuries to permanent teeth and 699 SEK (SD=1,239) for injuries to primary teeth. Multiple regression analysis of demographic and dental injury variables showed that complicated trauma was of special importance to costs for permanent and primary teeth injuries. The average relative increase in total costs to patients and companions for complicated injury to permanent teeth was 140% (95% confidence interval [CI], 66-248%) for patients and 132% (95% CI, 54-249%) for companions. Lack of access to a dental clinic near the place of residence could increase the average total costs of injuries to permanent teeth by 91% for companions (95% CI, 20-204%) and for primary teeth by 134% (95% CI, 38-296%).

CONCLUSIONS: Dental traumas result in both direct and indirect costs, with a predominance of direct costs. The direct costs primarily depend on degree of severity, while indirect costs are mostly due to compromised access to health care service. Traumas to permanent teeth are especially costly and, due to additional maintenance, the care may continue for several years. This study has drawn attention to the significant implications of dental trauma to patient and companion, a new area where further studies are warranted.

Place, publisher, year, edition, pages
2001. Vol. 29, no 2, 150-160 p.
Keyword [en]
adolescence, child, tooth injuries, costs, permanent dentition, primary dentition, regression analysis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13547DOI: 10.1111/j.1600-0528.2001.290210.xOAI: oai:DiVA.org:liu-13547DiVA: diva2:20937
Available from: 1999-02-27 Created: 1999-02-27 Last updated: 2009-05-15
In thesis
1. On Dental Trauma in Children and Adolescents: Incidence, Risk, Treatment, Time and Costs
Open this publication in new window or tab >>On Dental Trauma in Children and Adolescents: Incidence, Risk, Treatment, Time and Costs
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Dental trauma occur in childhood and adolescence with consequences in time and costs for both patient and family. The scientific knowledge of these matters is scarce. For some individuals, dental trauma will result in long, time-consuming and costly treatments in childhood which will continue into adulthood.

Aim: The thesis aimed to increase the knowledge of incidence, risk, treatment, time and costs spent on dental traumas to primary and permanent teeth in children and adolescents.

Material and method: The material for the studies emanated from the county of Västmanland, Sweden, and the municipality of Copenhagen, Denmark, and from a Swedish nation-wide material (Folksam). The material was collected from accident reports, dental files, dental trauma forms, questionnaires and telephone interviews. Descriptive, prospective and analytical methods were used. A classification of uncomplicated and complicated dental traumas was presented.

Results: The incidence of dental trauma to boys was higher, compared to girls, in the county of Västmanland in almost all age groups. For both sexes, the first years in life and the first years in school were the most accident prone periods with incidence twice as high as the average incidence for all children and adolescents in the county. Every third trauma was complicated with injuries to the pulp or periodontal ligaments. Every second patient with a dental trauma to permanent teeth suffered from multiple dental trauma episodes (MDTE) during a period of 12 years. In almost every second patient with MDTE, at least one of the affected teeth had sustained repeated trauma episodes. The risk of sustaining MDTE increased when the first trauma episode occurred in the age interval of 6-10, compared to 11-18 year olds. During a 12-year period, treatment times for complicated traumas were 2.0 and 2.7 times higher for primary and permanent teeth, respectively, compared to corresponding values for uncomplicated traumas. On average, direct time (treatment time) represented 11% and 16% of the total time, while the direct costs (health are service, transport, loss of personal property and medicine) represented 60% and 72% of the total costs of traumas to primary and permanent teeth, respectively, during a 2-year period for cases of a nation-wide material.

Conclusion: Dental traumas are frequent and some individuals are injured several times. Besides treatment time, efforts from the family are substantial in time and costs. Parameters such as degree of severity, access to treatment and place of injury are of major importance to both patient and family and should be considered when calculating time and costs of dental trauma in children and adolescents.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2000. 52 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 624
Keyword
adolescence, child, time, incidence, costs, permanent dentition, primary dentition, risk, tooth injuries
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-5016 (URN)91-7219-581-9 (ISBN)
Public defence
2000-04-28, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Supervisors
Available from: 1999-02-27 Created: 1999-02-27 Last updated: 2012-01-24Bibliographically approved

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Glendor, UlfJonsson, DickLindqvist, Kent

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