A System Dynamics Model for Long-term Aspect of Caries Preventive Interventions

Abstract

Abstract             Objective: The purpose of the study is to appraise the long-term effects of caries preventive interventions of the Ministry of Public Health (MOPH), Thailand: supervised toothbrushing (STB), dental sealant, and combined STB+sealant that are implemented for 6- to 15-year-olds by comparing with the base case using the System Dynamics Model (SDM). Method: The System Dynamics Model (SDM) was analyzed to compare the interventions, supervised toothbrushing (STB), sealant, and combined STB+sealant as intervention scenarios with the base case scenario. The effectiveness data of interventions set in the model were retrieved from meta-analyses and experts’ opinions. Results: The model established that the no caries population increased by 36.2%, 25.5%, and 18.6% while the caries population decreased by 8.1%, 5.6%, and 3.3% under combined STB+sealant, sealant, and supervised toothbrushing (STB) respectively compared to the base case at the age of 15 years old. From the above 20 years old to the elderly age, both individual and combined interventions have no favorable effect on reducing caries. On the other hand, the no caries population under the interventions is not significantly different from the base case during the elderly age. Conclusion: Combined STB+sealant is the most effective intervention among the interventions that are administered during the age of 6-15 years. The interventions given during these ages have effectiveness in caries reduction by about 15 years from when they are started. In addition, System Dynamics Model (SDM) would assist in comparing the interventions or policies as scenarios to indicate the most opportune one for the population.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study received ethical approval from the Human Research Ethics Committee of the Faculty of Dentistry, Prince of Songkla University, EC6503-011 on 7 March 2022.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All relevant data are within the manuscript and its Supporting Information files.

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