***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Economic evaluations provide an important basis for allocation of re sources and health services planning . The aim of this study was to evaluate and compare the costs of correcting anterior crossbite with functional shift , using fixed or removable appliances ( FA or RA )  and to relate the costs to the effects , using cost-minimization analysis . DESIGN , SETTING , AND PARTICIPANTS Sixty-two patients with anterior crossbite and functional shift were r and omized in blocks of 10 . Thirty-one patients were r and omized to be treated with brackets and arch wire ( FA ) and 31 with an acrylic plate ( RA ) . Duration of treatment and number and estimated length of appointments and cancellations were registered . Direct costs ( premises , staff salaries , material , and laboratory costs ) and indirect costs ( the accompanying parents ' loss of income while absent from work ) were calculated and evaluated with reference to successful outcome alone , to successful and unsuccessful outcomes and to re-treatment when required . Societal costs were defined as the sum of direct and indirect costs . INTERVENTIONS Treatment with FA or RA . RESULTS There were no significant differences between FA and RA with respect to direct costs for treatment time , but both indirect costs and direct costs for material were significantly lower for FA . The total societal costs were lower for FA than for RA . LIMITATIONS Costs depend on local factors and should not be directly extrapolated to other locations . CONCLUSION The analysis disclosed significant economic benefits for FA over RA . Even when only successful outcomes were assessed , treatment with RA was more expensive . TRIAL REGISTRATION This trial was not registered . PROTOCOL The protocol was not published before trial commencement OBJECTIVES The Access to Baby and Child Dentistry ( ABCD ) Program addresses the needs of families in obtaining dental care . In this study , the program was evaluated in rural Stevens County , Washington . Aims were to assess utilization of dental services , average dental expenditures per child , and oral health status . METHODS Medicaid-enrolled children aged 1 - 4 years were r and omly assigned to the ABCD program ( n=216 ) or to regular benefits ( n=221 ) . An outreach worker contacted each ABCD family and provided an orientation .  Dental care utilization and expenditures were calculated from cl aims . A posttest-only design was used to evaluate oral health status . RESULTS An enrollment effect was seen in ABCD , but the difference between groups was not sustained . There was a doubling of utilization between groups for the youngest cohort , while the others showed no differences . In the first year the rate was higher for the entire ABCD group than for the children not in ABCD ( 34.0 % vs 24.7 % ) . Thirty-three percent of ABCD children ( 70/212 ) who had visited the dentist had > 1 appointment compared to 21.5 percent ( 47/219 ) for the children not in ABCD who had visited the dentist . There was no overall difference in expenditures , while expenditures for preventive services were greater for ABCD . ABCD children had fewer teeth with initial caries . The average incremental cost per child per initial lesion prevented was 31.44 dollars . CONCLUSION ABCD most benefited the youngest cohort of children and improved health OBJECTIVE A growing number of studies have investigated the prevalence of  Molar Incisor Hypomineralization ( MIH )  around the world . The aim of this study was to systematic ally estimate the pooled prevalence of MIH . METHODS A comprehensive literature research was completed in English and Chinese data bases . R and om effect models were used to calculate the pooled prevalence . To address the heterogeneity , meta-regression , and sensitivity analyzes were conducted . Publication bias was estimated by trim and fill method . RESULTS Seventy eligible studies were included . The pooled prevalence of MIH was 14.2 % globally . In subgroup analysis , South America ( 18.0 % , 95 % CI : 13.8 - 22.2 ) and Spain ( 21.1 % , 95 % CI : 17.7 - 24.6 ) had the highest prevalence . There was no significant difference between males ( 14.3 % , 95 % CI : 12.0 - 16.6 ) and females ( 14.4 % , 95 % CI : 12.8 - 15.9 ) . The prevalence of MIH among children 10 years of age or younger ( 15.1 % , 95 % CI : 12.1 - 18.2 ) was much higher than the prevalence of MIH among older children ( 12.1 % , 95 % CI : 8.0 - 16.3 ) . Sample size explained 15.7 % heterogeneity . CONCLUSION MIH has a high incidence globally , especially among children < 10 years old . It is , therefore , imperative to develop more appropriate dental healthcare strategies to care for these children and to identify the etiology of MIH to prevent it occurring BACKGROUND Dental caries is the most common disease of childhood . The NHS guidelines promote preventative care in dental practice s , particularly for young children . However , the cost-effectiveness of this policy has not been established . OBJECTIVE To measure the effects and costs of a composite fluoride intervention design ed to prevent caries in young children attending dental services . DESIGN The study was a two-arm , parallel-group , r and omised controlled trial , with an allocation ratio of 1 : 1 . R and omisation was by clinical trials unit , using r and omised permuted blocks . Children/families were not blinded ; however , outcome assessment was blinded to group assessment . SETTING The study took place in 22 NHS dental practice s in Northern Irel and , UK . PARTICIPANTS The study participants were children aged 2 - 3 years , who were caries free at baseline . INTERVENTIONS The intervention was composite in nature , comprising a varnish containing 22,600 parts per million ( p.p.m . ) fluoride , a toothbrush and a 50-ml tube of toothpaste containing 1450 p.p.m . fluoride ; plus st and ardised , evidence -based prevention advice provided at 6-monthly intervals over 3 years . The control group received the prevention advice alone . MAIN OUTCOME MEASURES The primary outcome measure was conversion from caries-free to caries-active states . Secondary outcome measures were the number of decayed , missing or filled tooth surfaces in primary dentition ( dmfs ) in caries-active children , the number of episodes of pain , the number of extracted teeth and the costs of care . Adverse reactions ( ARs ) were recorded . RESULTS A total of 1248 children ( 624 r and omised to each group ) were recruited and 1096 ( 549 in the intervention group and 547 in the control group ) were included in the final analyses . A total of 87 % of the intervention children and 85 % of control children attended every 6-month visit ( p = 0.77 ) . In total , 187 ( 34 % ) children in the intervention group converted to caries active , compared with 213 ( 39 % ) in the control group [ odds ratio ( OR ) 0.81 , 95 % confidence interval ( CI ) 0.64 to 1.04 ; p = 0.11 ] . The mean number of tooth surfaces affected by caries was 7.2 in the intervention group , compared with 9.6 in the control group ( p = 0.007 ) . There was no significant difference in the number of episodes of pain between groups ( p = 0.81 ) . However , 164 out of the total of 400 ( 41 % ) children who converted to caries active reported toothache , compared with 62 out of 696 ( 9 % ) caries-free children ( OR 7.1 95 % CI 5.1 to 9.9 ; p < 0.001 ) . There was no statistically significant difference in the number of teeth extracted in caries-active children ( p = 0.95 ) . Ten children in the intervention group had ARs of a minor nature . The average direct dental care cost was £ 155.74 for the intervention group and £ 48.21 for the control group over 3 years ( p < 0.05 ) . The mean cost per carious surface avoided over the 3 years was estimated at £ 251.00 . LIMITATIONS The usual limitations of a trial such as generalisability and underst and ing the underlying reasons for the outcomes apply . There is no mean willingness-to-pay threshold available to enable assessment of value for money . CONCLUSIONS A statistically significant effect could not be demonstrated for the primary outcome . Once caries develop , pain is likely . There was a statistically significant difference in dmfs in caries-active children in favour of the intervention . Although adequately powered , the effect size of the intervention was small and of question able clinical and economic benefit . FUTURE WORK Future work should assess the caries prevention effects of interventions to reduce sugar consumption at the population and individual levels . Interventions design ed to arrest the disease once it is established need to be developed and tested in practice . TRIAL REGISTRATION Current Controlled Trials IS RCT N36180119 and EudraCT 2009 - 010725 - 39 . FUNDING This project was funded by the National Institute for Health Research ( NIHR ) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol . 20 , No. 71 . See the NIHR Journals Library website for further project information The aim of this study was to assess the cost-effectiveness of an experimental caries-control regimen in a r and omized clinical trial ( RCT ) conducted in Pori , Finl and , in 2001 - 2005 . Children ( n = 497 ) who were 11 - 12 yr of age and had at least one active initial caries lesion at baseline were studied . The children in the experimental group ( n = 250 ) were offered an individually design ed patient-centered regimen for caries control . The children in the control group ( n = 247 ) received st and ard dental care . Furthermore , the whole population was exposed to continuous community-level oral health promotion .  Individual costs of treatment procedures and outcomes ( DMFS increment score ) for the follow-up period of 3.4 yr were calculated for each child in both groups . The incremental cost-effectiveness ratio was euro 34.07 per averted DMF surface . The experimental regimen was more effective , and also more costly . However , the total costs decreased year after year , and for the last 2 yr the experimental regimen was less expensive than the st and ard dental care . The experimental regimen would probably have been more cost-effective than st and ard dental care if the follow-up period had been longer , the regimen less comprehensive , and /or if dental nurses had conducted the preventive procedures OBJECTIVE Paediatric dental care under general anaesthesia among preschool children in Western Australia is increasing and costly . This study assessed cost-effectiveness of the atraumatic restorative treatment-based ( ART-based ) approach against the st and ard care ( SC ) approach to managing early childhood caries in a primary care setting based on a 1-year pragmatic r and omized controlled trial . METHODS Cost-effectiveness analysis , from the service provider perspective , was conducted . Outcomes include number of referral to specialists and dental treatments . One-way and probabilistic sensitivity analyses were undertaken to test the robustness of the cost-effectiveness estimates . RESULTS Six children in the ART-based group and 62 children in the SC group ( n = 127 each group ) were referred for paediatric dental specialist care . Children in the ART-based group received more dental services than those allocated to the SC group ( mean = 3.8 , SD 2.0 and mean = 1.8 , SD 1.8 , respectively , Wilcoxon rank-sum test , P < 0.01 ) . Total costs of the ART-based approach and the SC group were $ 137 860 and $ 178 217 , respectively . Based on probabilistic sensitivity analysis , $ 654 was saved per referral to specialist avoided and $ 36 was saved per additional dental treatment . The probability that the ART-based approach is cost-saving was 63 % . Specialist dental treatment fees had a big impact on the cost-effectiveness estimates . CONCLUSION The ART-based approach appears to be a worthwhile intervention because it result ed in fewer referred cases and enabled more treatments to be provided with cost-savings OBJECTIVES A total of 3373 12-year-olds agreed to participate in an intervention study evaluating different caries preventive measures .  The study , titled ' Evaluation of caries preventive measures ' , was performed between 1995 and 1999 at 26 dental health clinics throughout Sweden . At the start of the study , the subjects were classified as individuals at high or low risk of developing caries . The high-risk group consisted of 1165 subjects . The children in the high-risk group were r and omly assigned to one of four preventive programs . The programs represent a step-wise increase in fluoride content , contact with dental personnel and cost . The aim of the present cost-effectiveness analysis ( CEA ) study performed from a societal perspective is to compare costs and consequences of  caries preventive programs  in a caries high-risk population . By ' costs ' is meant both treatment costs and costs contributed by the patient and the patient 's family . Costs contributed by patients and their families consist of out-of-pocket expenses , transportation costs , and time . Conclusions are that it is important to consider the perspective from which a study is carried out . Costs contributed by the patient and the patient 's family have a high impact on total costs for children and younger adolescents but decrease with time as the adolescents get older . The present study shows an incremental cost-effectiveness of 2043 SEK (  
    Output:
    
Conclusions There is a paucity of high- quality economic evaluations in the field of child oral health .