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

ObjectiveThe 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). MethodThe 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. ResultsThe 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. ConclusionCombined 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.