ORIGINAL ARTICLE: EPIDEMIOLOGY, CLINICAL PRACTICE AND HEALTH Cost-minimization analysis of a tailored oral health intervention designed for immigrant older adults Rodrigo J Mariño, 1 Jorge Fajardo, 1 Hanny Calache 2 and Mike Morgan 1 1 Melbourne Dental School, University of Melbourne, and 2 Dental Health Services Victoria, Melbourne, Victoria, Australia Aim: This paper presents an economic evaluation, from a societal viewpoint, comparing a community-based oral health promotion program aimed at improving the gingival health of immigrant older adults, with one-on-one chairside oral hygiene instructions at a public dental clinic in Melbourne, Australia. Methods: The costs associated with implementing and operating the oral health promotion program were identified and measured using 2008 prices. The intervention was based on the Oral Health Information Seminars/Sheets model, and consisted of 10 20-min oral hygiene group seminars and four 10-min supervised individual brushing sessions carried out by a non-oral health professional educator. Health outcomes were measured as a reduction in gingival bleeding. Clinical data showed a 75% reduction in mean gingival bleeding scores among those who took part in the intervention. A population of 100 active, independent-living older adults living in Melbourne, and members of Italian social clubs, was used for modeling in this analysis. Results: This analysis estimated that if an oral hygiene program using the Oral Health Information Seminars/Sheets model was available to 100 older adults, the net cost from a societal perspective would be AUD$6965.20. In comparison, a standard individual oral hygiene instruction program, at public dental clinics, given equivalent levels of case complexity and assuming the same level of effectiveness, would cost AUD$40 185.00. Per participant cost of a community-based oral health promotion program was $69.65 versus $401.85 for chairside instruction. Conclusions: Findings confirm that community-based oral health interventions are highly cost-effective and an efficient use of society’s financial resources. Geriatr Gerontol Int 2014; 14: 336–340. Keywords: cost-minimization, elderly, emigrants and immigrants, health promotion, oral health. Introduction Improvements in oral health in Australia over the past 50 years have translated into a greater number of older people retaining more teeth, increasing the likelihood of both coronal and root caries, and periodontal disease in these age groups. These oral diseases place a consider- able burden on individuals, families and the commu- nity. Gum (periodontal) disease, for example, is the fifth most prevalent health problem. 1 It is possible for oral bacteria to enter the bloodstream, which can cause sys- temic problems, especially for people without a healthy immune system. 2 A range of health conditions associ- ated with periodontal infection can also have an adverse effect on glycemic control and the incidence of diabetes complications. 3 The two most common gum diseases are gingivitis and periodontitis. Gingivitis is a reversible inflammation of the gum tissue, characterized by redness, swelling and bleeding. Periodontitis is the chronic, non- reversible destruction of the soft tissues and bones that support the teeth. In advanced periodontitis, teeth can become lose and need to be extracted. However, peri- odontal health can be maintained successfully with adequate oral hygiene, and periodontal therapy and maintenance. 4–6 Despite these factors, coordinated oral health promotion programs designed to improve the oral health status of this section of the population are almost non-existent in the Australian state of Victoria. A culturally appropriate, community-based oral health promotion program was designed for Italian older adults living in Melbourne, Australia. The program, known as Oral Health Information Seminars/ Sheets (ORHIS), consisted of 10 interactive oral health Accepted for publication 1 May 2013. Correspondence: Dr Rodrigo Mariño PhD, Oral Health Cooperative Research Centre, Melbourne Dental School, University of Melbourne, Melbourne, VIC 3010, Australia. Email: rmarino@unimelb.edu.au Geriatr Gerontol Int 2014; 14: 336–340 336 | © 2013 Japan Geriatrics Society doi: 10.1111/ggi.12103