Scale and polish (SP) and oral hygiene advice (OHA) are commonly provided in primary care dental practice to help prevent periodontal disease. These services are widely consumed by service users, incurring substantial cost, without any clear evidence of clinical benefit. This article aims to elicit general population preferences and willingness to pay (WTP) for preventative dental care services and outcomes. An online discrete-choice experiment (DCE) was completed by a nationally representative sample of the UK general population. Respondents each answered 10 choice tasks that varied in terms of service attributes (SP, OHA, and provider of care), outcomes (bleeding gums and aesthetics), and cost. Choice tasks were selected using a pivoted segmented experimental design to improve task realism. An error components panel logit model was used to analyze the data. Marginal WTP (mWTP) for each attribute and level was calculated. In total, 667 respondents completed the DCE. Respondents valued more frequent SP, care provided by a dentist, and personalized OHA. Respondents were willing to pay for dental packages that generated less frequent (“never” or “hardly ever”) bleeding on brushing and teeth that look and feel at least “moderately clean.” Respondents were willing to pay more (+£145/y) for improvements in an aesthetic outcome from “very unclean” (−£85/y) to “very clean” (+£60/y) than they were for reduced bleeding frequency (+£100/y) from “very often” (−£54/y) to “never” (+£36/y). The general population value routinely provided SP, even in the absence of reductions in bleeding on brushing. Dental care service providers must consider service user preferences, including preferences for both health and nonhealth outcomes, as a key factor in any service redesign. Furthermore, the results provide mWTP estimates that can be used in cost-benefit analysis of these dental care services.
We thank all of the respondents to our survey who took the time to share their opinions and preferences with us, as well as all members of the IQuaD study team who provided input, advice, and comments on draft versions of the survey.
Open Access via the Jisc Sage Open Access Agreement
Funder - national institute for health research
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project was funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme (project number: 09/01/45). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Department of Health or the funders that provide institutional support for the authors of this report. The Health Economics Research Unit and the Health Services Research Unit are funded by the Chief Scientist Office of the Scottish Government
Health and Social Care Directorates
- oral hygiene advice
- scale and polish
- willingness to pay
- stated preference