Comparing the cost of disposable and reusable instruments in dental health practice

Marcin Sowa¹, Jonas Fooken², Kelly McGowan³, Stephen Birch⁴

1 Centre for the Business and Economics of Health, The University of Queensland, Queensland, Australia; Contact: m.sowa@uq.edu.au

2 Centre for the Business and Economics of Health, The University of Queensland, Queensland, Australia

3 Oral Health Service, West Moreton Health, Ipswich, Queensland, Australia; School of Dentistry, The University of Queensland, Herston, Queensland, Australia

4 Centre for the Business and Economics of Health, The University of Queensland, Queensland, Australia; Centre for Health Economics, The University of Manchester, Manchester, UK

Objective: To assess the cost of mixed dental instrumentation currently used in West Moreton Oral Health Service relative to strategies comprising reusable instruments (RIs) or disposable instruments (DIs) only.

Methods: We developed a model for dental instruments reflecting the cost of procurement, reprocessing and disposal. The model was used to compare current practice to RI-only and DI-only strategies in specific applications (four types of instrument sets) and, on a larger scale, considering the annual volume of instruments used in the organisation. We explored scenarios concerning cost factors, including instrument prices, lifespans, the cost of reprocessing and waste disposal, and couriering, by varying their values from the base case.

Results: At the organisation level, RI-only was the lowest cost strategy (A$1.23m per year) followed by the current mix of instruments which was 4% more costly (A$1.28m). However, with declining DI prices or increasing labour costs current practice would become the lowest cost option. In terms of specific instrument sets, DI-only offered the lowest cost option for oral examinations (A$6.29), and the current practice of mixed instrumentation – for simple extractions (A$16.56). RI-only sets were the least costly in resource intensive applications such as surgical extractions (A$40.19) and restorations (A$43.83).

Conclusions: RIs are generally less costly than DIs, but for specific instrument sets the outcome depends on the type of procedure. In some circumstances, mixed instrumentation can provide the lowest cost alternative. Even when not minimising cost, the use of mixed instrumentation may help mitigate operational risks and input market uncertainty.