Document Type : Research Article (s)

Authors

Department of Public Health Dentistry, V S Dental College and Hospital, Bengaluru, India

Abstract

Background: Oral diseases remain one of the major public health challenges in India. Mobile dental services may be used as alternatives to supplement the standard care in order to reach underserved populations in several countries. However, not enough research has been conducted on school children. Hence, this paper aimed to evaluate the cost-effectiveness (where cost is expressed in monetary units and results in non-monetary units) of a mobile dental vehicle (MDV) in delivering primary oral health care among adopted schools of a dental college in Bengaluru.
Methods: This retrospective population-based study was conducted among adopted children of the age group of 4–15 years in Bengaluru. The data were collected from the college camp out-patient register over three academic years of 2017-18, 2018-19, and 2019-20 in December 2020. Cost-effectiveness was calculated utilizing the formula total cost (direct+indirect) of service provision with the total number of the patients who used the services in the same period. Statistical tests unpaired student t-test, ANOVA, Tukey’s post hoc test, and all the statistical tests were set with a level of significance (p <0.1), which was conducted using the statistical package SPSS version 19.0.
Results: A total of 14,806 patients and 75,421 teeth were treated in mobile dental vehicle. The cost for each patient was around 259.0/- rupees and for each tooth, around 51.3/-rupees. Around 2686 teeth were benefitted from the use of a portable dental chair. Therefore, the cost of treating each tooth was around 12.3/- rupees. The mean difference in the number of the treated patients was found to be significantly decreasing.
Conclusion: We conducted the current study to demonstrate the costs of providing primary oral health care among adopted schools. Mobile dental vehicle and the portable dental chair were found to be cost-effective in delivering primary oral health care.

Keywords

1. Gambhir RS, Kaur A, Singh A, Sandhu ARS, Dhaliwal APS. Dental public health in India: An insight. J Family Med Prim Care. 2016;5(4):747-751. doi: 10.4103/2249-4863.201155. PubMed PMID: 28348984; PubMed Central PMCID: PMC5353807. ## 2. Ganavadiya R, Chandrashekar Br, Goel P, Hongal Sg, Jain M. Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model. Ann Med Health Sci Res. 2014;4(3):293-304. doi: 10.4103/2141-9248.133364. PubMed PMID: 24971198; PubMed Central PMCID: PMC4071723. ## 3. Rema Nagarajan, Dentists or doctors, can just adding to numbers work? [cited 2019 April 21]. Available from: https://timesofindia.indiatimes.com/india/dentists-or-doctors-can-just-adding-to-numbers-work/articleshow/68979529.cms accessed on 02/03/2020. ## 4. Chandramouli C. Rural urban distribution of population. Census of India; 2011. Available from: censusindia.gov. in/2011-prov-results/ paper2/ Rural_Urban_2011.pdf. accessed on 05/03/2020. ## 5. Shekar BRC, Manjunath BC, Reddy CVK, , Shekar S. Dental health awareness, attitude, oral health-related habits, and behaviors in relation to socio-economic factors among the municipal employees of Mysore city. Annals of Tropical Medicine and Public Health. 2011;4(2):99. doi: 10.4103/1755-6783.85761. ## 6. AlJehani YA. Risk factors of periodontal disease: review of the literature. Int J Dent. 2014;2014:182513. doi: 10.1155/2014/182513. PubMed PMID: 24963294; PubMed Central PMCID: PMC4055151. ## 7. Yadav S, Rawal G. The current status of dental graduates in India. Pan Afr Med J. 2016;23:22. doi: 10.11604/pamj.2016.23.22.7381. PubMed PMID: 27200127; PubMed Central PMCID: PMC4856508. ## 8. Goel P, Goel A, Torwane NA. Cost-efficiency of indigenously fabricated mobile-portable dental unit in delivery of primary healthcare in rural India. J Clin Diagn Res. 2014;8(7):ZC06-9. doi: 10.7860/JCDR/2014/8351.4534. PubMed PMID: 25177627; PubMed Central PMCID: PMC4149133. ## 9. Vashishtha V, Kote S, Basavaraj P, Singla A, Pandita V, Malhi RK. Reach the unreached–a systematic review on mobile dental units. J Clin Diagn Res. 2014;8(8):ZE05-8. doi: 10.7860/JCDR/2014/8688.4717. PubMed PMID: 25302288; PubMed Central PMCID: PMC4190815. ## 10. Rudolph MJ, Chikte UM, Lewis HA. A mobile dental system in Southern Africa. J Public Health Dent. 1992;52(2):59-63. doi: 10.1111/j.1752-7325.1992.tb02244.x. PubMed PMID: 1564692. ## 11. Sandesh N, Nagarajappa R, Hussain SA, Ramesh G, Singla A, Prabhusankar K. Utilization of mobile dental vans at post graduate dental institutions in India. Oral Health Dent Manag. 2014;13(1):20-6. PubMed PMID: 24603911. ## 12. Dang A, Likhar N, Alok U. Importance of Economic Evaluation in Health Care: An Indian Perspective. Value Health Reg Issues. 2016;9:78-83. doi: 10.1016/j.vhri.2015.11.005. PubMed PMID: 27881265. ## 13. Haslinda N, Juni MH, Rosliza AM, Faisal I. Designing and conducting cost-effectiveness analysis studies in healthcare. International Journal of Public Health and Clinical Sciences. 2017;4(5):62-76. ## 14. Rifkin SB. Alma Ata after 40 years: Primary Health Care and Health for All—from consensus to complexity. BMJ Glob Health. 2018;3(Suppl 3):e001188. doi: 10.1136/bmjgh-2018-001188. PubMed PMID: 30622747; PubMed Central PMCID: PMC6307566. ## 15. Gambhir RS, Brar P, Singh G, Sofat A, Kakar H. Utilization of dental care: An Indian outlook. J Nat Sci Biol Med. 2013;4(2):292-7. doi: 10.4103/0976-9668.116972. PubMed PMID: 24082719; PubMed Central PMCID: PMC3783767. ## 16. Mishra P, Dasar P, Sandesh N, Kumar S, Chand BR, Airen B, Jain D, Warekar S. Dental Camp Experience in Lifeline Express (LLE) Train among Rural Population of Central, India. J Clin Diagn Res. 2014;8(11):ZC72-74. doi: 10.7860/JCDR/2014/11378.5157. PubMed PMID: 25584322; PubMed Central PMCID: PMC4290333. ## 17. Dawkins E, Michimi A, Ellis-Griffith G, Peterson T, Carter D, English G. Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study. BMC Oral Health. 2013;13:19. doi: 10.1186/1472-6831-13-19. PubMed PMID: 23639250; PubMed Central PMCID: PMC3653808. ## 18. Molete MP, Chola L, Hofman KJ. Costs of a school-based dental mobile service in South Africa. BMC Health Serv Res. 2016;16(1):590. doi: 10.1186/s12913-016-1827-2. PubMed PMID: 27756293; PubMed Central PMCID: PMC5069863. ## 19. Yu SWY, Hill C, Ricks ML, Bennet J, Oriol NE. The scope and impact of mobile health clinics in the United States: a literature review. Int J Equity Health. 2017;16(1):178. doi: 10.1186/s12939-017-0671-2. PubMed PMID: 28982362; PubMed Central PMCID: PMC5629787. ##