{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T14:10:56Z","timestamp":1779804656957,"version":"3.53.1"},"reference-count":22,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"1","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dental caries are common oral health conditions among Medicaid beneficiaries. Silver diamine fluoride (SDF) has been applied to manage dental caries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objectives\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the cost-effectiveness of SDF application for managing high-risk root caries within the context of Medicaid, a Markov simulation model was adopted from a healthcare system perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 45-year-old subject with 21 residual teeth was simulated for 19 years. Twice-yearly 38% SDF application on the tooth surface at risk for caries was compared with 5% sodium fluoride (NaF) varnish in terms of effectiveness and cost. Tooth-years free of extraction were set as the effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with 5% NaF varnish, 38% SDF application was cost-effective, with a difference of 6.34 extraction-free tooth-years and an additional cost of $7798 (incremental cost-of-effectiveness ratio, $1229 per extraction-free tooth-year gained; incremental net monetary benefit, $309\u2009355). One-way sensitivity analyses on SDF and NaF costs confirmed cost-effectiveness of SDF application over NaF varnish.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An integrated orosystemic care model is underscored to disseminate the benefits of SDF application as the Medicaid payment system shifts from fee-for-service to managed care. Semiannual 38% SDF application might reduce and delay tooth extraction due to root caries in statewide dental provider shortage areas, particularly \u201cdental deserts,\u201d where Medicaid-accepting dentists are not available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.36469\/001c.160210","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T14:54:58Z","timestamp":1778770498000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":0,"title":["Managing High-Risk Root Caries with Silver Diamine Fluoride Application: A Markov Simulation Study"],"prefix":"10.36469","volume":"13","author":[{"given":"Young S.","family":"Kim","sequence":"first","affiliation":[{"name":"Korea University Guro Hospital, Seoul, Republic of Korea","department":["Department of Anesthesiology and Pain Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7196-8682","authenticated-orcid":true,"given":"Ji W.","family":"Yoo","sequence":"additional","affiliation":[{"name":"Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada, USA","department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Tabrizi","sequence":"additional","affiliation":[{"name":"UNLV School of Dental Medicine, Las Vegas, Nevada, USA","department":["Department of Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-In","family":"Ryu","sequence":"additional","affiliation":[{"name":"Kyung Hee University College of Dentistry, Seoul, Republic of Korea","department":["Department of Preventive and Social Dentistry"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonsu","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Public Health, UNLV, Las Vegas, Nevada, USA","department":["Department of Healthcare Administration and Policy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Chong","sequence":"additional","affiliation":[{"name":"Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada, USA","department":["Department of Family and Community Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Hun","family":"Han","sequence":"additional","affiliation":[{"name":"Seoul National University School of Dentistry, Seoul, Republic of Korea","department":["Department of Preventive and Social Dentistry"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Ho","family":"Won","sequence":"additional","affiliation":[{"name":"Hongik University College of Engineering, Seoul, Republic of Korea","department":["Department of Urban Design and Planning"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoohwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Howard Hughes College of Engineering, UNLV, Las Vegas, Nevada, USA","department":["Department of Computer Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia","family":"Ioanitoaia-Chaudhry","sequence":"additional","affiliation":[{"name":"VA Southern Nevada Healthcare System, North Las Vegas, Nevada, USA","department":["Geriatric Education Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Tonopah Dental Center, Tonopah, Nevada, USA"},{"name":"Nevada Dental Foundation, Carson City, Nevada, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia","family":"Loo","sequence":"additional","affiliation":[{"name":"UNLV School of Dental Medicine, Las Vegas, Nevada, USA","department":["Department of Clinical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson","family":"Penna","sequence":"additional","affiliation":[{"name":"The Connection Sphere, Las Vegas, Nevada, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22273","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"12917","DOI":"10.3390\/ijerph191912917","article-title":"Silver diamine fluoride (SDF) efficacy in arresting cavitated caries lesions in primary molars: a systematic review and metaanlysis","volume":"19","author":"L. 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