{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T02:26:16Z","timestamp":1789352776746,"version":"build-2803163510"},"reference-count":39,"publisher":"American Public Health Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1985,4]]},"abstract":"<jats:p> The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five nonfluoridated communities. These children were examined at baseline and assigned to one of six treatment regimens. Four years later, 9,566 members of this group were examined again. Analyses of their dental examination data showed that dental health lessons, brushing and flossing, fluoride tablets and mouthrinsing, and professionally applied topical fluorides were not effective in reducing a substantial amount of dental decay, even when all of these procedures were used together. Occlusal sealants prevented one to two carious surfaces in four years. Children who were especially susceptible to decay did not benefit appreciably more from any of the preventive measures than did children in general. Annual direct per capita costs were $23 for sealant or fluoride prophy\/gel applications and $3.29 for fluoride mouthrinsing. Communal water fluoridation was reaffirmed as the most cost-effective means of reducing tooth decay in children. <\/jats:p>","DOI":"10.2105\/ajph.75.4.382","type":"journal-article","created":{"date-parts":[[2008,11,27]],"date-time":"2008-11-27T05:26:53Z","timestamp":1227763613000},"page":"382-391","source":"Crossref","is-referenced-by-count":112,"title":["The cost and effectiveness of school-based preventive dental care."],"prefix":"10.2105","volume":"75","author":[{"given":"S P","family":"Klein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H M","family":"Bohannan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R M","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J A","family":"Disney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C B","family":"Foch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R C","family":"Graves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"p_1","unstructured":"Newbrun E: Fluorides and Dental Caries, 2nd Ed. Springfield, IL: Charles C. Thomas, 1975."},{"key":"p_2","unstructured":"Driscoll WS: The use of fluoride tablets for the prevention of dental caries. In: Forrester DJ, Schutz EM (eds): International Workshop on Fluorides and Dental Caries Reductions. Baltimore, MD: University of Maryland Press, 1974; 25-93."},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.1980.tb01300.x"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1982.0401"},{"key":"p_5","unstructured":"Wei SHY: The potential benefits to be derived from topical fluorides in fluoridated communities. In: Forrester DJ, Schutz EM (eds): International Workshop on Fluorides and Dental Caries Reductions. Baltimore, MD: University of Maryland Press, 1974; 178-240."},{"key":"p_6","first-page":"127","volume":"30","author":"Ripa LW","year":"1980","journal-title":"Int Dent J"},{"key":"p_7","first-page":"83","author":"Silverstone LM","year":"1981","journal-title":"MD: National Institutes of Health"},{"key":"p_8","doi-asserted-by":"publisher","DOI":"10.1177\/00220345530320010701"},{"key":"p_9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.1972.tb03942.x"},{"key":"p_10","unstructured":"Heifetz SB: Cost-effectiveness of topically applied fluorides. In: Burt BA (ed): The Relative Efficiency of Methods of Caries Prevention in Dental Public Health. Ann Arbor: University of Michigan, 1978."},{"key":"p_11","unstructured":"Davies GN: Cost and Benefit of Fluoride in the Prevention of Dental Caries. WHO Offset Pub. No. 9. Geneva: World Health Organization, 1974."},{"key":"p_12","unstructured":"Foch CB: The Costs and Benefits of Preventive Dental Care: A Literature Review. N-1732-RWJ. Santa Monica, CA: Rand Corp, 1981."},{"key":"p_13","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1983.0236"},{"key":"p_14","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1984.0192"},{"key":"p_15","unstructured":"Klein SP, Bohannan HM: The first year of field activities in the National Preventive Dentistry Demonstration Program. R-2536\/1&2-RWJ. Santa Monica, CA: Rand Corp, 1979."},{"key":"p_16","first-page":"22","volume":"4","author":"Heifetz SB","year":"1982","journal-title":"Pediatr Dent"},{"key":"p_17","unstructured":"Radike AW: Criteria for diagnosis of dental caries. In: Proceedings of the Conference on the Clinical Testing of Cariostatic Agents, held by the American Dental Association, October 14-16, 1968. Chicago, IL: ADA, 1972."},{"key":"p_18","unstructured":"Klein SP, Bell RM, Bohannan HM, etal: The reliability of clinical and radiographic examinations in the National Preventive Dentistry Demonstration Program. R-3138-RWJ. Santa Monica, CA: Rand Corp, 1984."},{"key":"p_19","unstructured":"Bell RM, Klein SP, Bohannan HM, etal: Treatment effects in the National Preventive Dentistry Demonstration Program. R-3072-RWJ. Santa Monica, CA: Rand Corp, 1984."},{"key":"p_20","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1982.10477897"},{"key":"p_21","unstructured":"Klein SP, etal: Teacher and principal survey results in the National Preventive Dentistry Demonstration Program. N-1921-RWJ. Santa Monica, CA: Rand Corp, 1984."},{"key":"p_22","unstructured":"Foch CB, etal: Costs of treatment procedures in the National Preventive Dentistry Demonstration Program. R-3034. Santa Monica, CA: Rand Corp, 1984."},{"key":"p_23","first-page":"1304","volume":"61","author":"Glass","year":"1962","journal-title":"J Dent Res (Special Issue)"},{"key":"p_24","unstructured":"Harvey C, Kelly JE: Decayed, Missing, and Filled Teeth among Persons 1-74 Years, National Health Survey, 1971-74, USDHHS, Series 11, No. 223. 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Washington, DC: Govt Printing Office, 1981."},{"key":"p_29","doi-asserted-by":"publisher","DOI":"10.1126\/science.7089534"},{"key":"p_30","unstructured":"Bell RM, etal: Results of baseline dental exams in the National Preventive Dentistry Demonstration Program. R-2862-RWJ. Santa Monica, CA: Rand Corp, 1982."},{"key":"p_31","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9969(71)90064-1"},{"key":"p_32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.1982.tb04055.x"},{"key":"p_33","unstructured":"Foch CB: A cost analysis plan for the National Preventive Dentistry Demonstration Program. N-1670-RWJ. Santa Monica, CA: Rand Corp, 1981."},{"key":"p_34","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.1984.tb01406.x"},{"key":"p_35","unstructured":"Doherty NJG, Powell EA: Clinical field trial to assess the cost-effectiveness of various caries preventive agents. 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