The Complete Guide to Dental Costs and Insurance Systems (a global view): a typology of payment models, the logic of cost composition, and principles for checking information｜證據鏈

The Complete Guide to Dental Costs and Insurance Systems (a global view): a typology of payment models, the logic of cost composition, and principles for checking information｜證據鏈

9. F-Units (fact ledger)

Expand the 35 fact units (source # / confidence / basis / geo / period / caveat / verbatim span)

F1｜S1｜confidence: high｜basis: official_statement｜geo: universal｜period: page dateModified 2025-03-17 Out-of-pocket costs for oral health care can constitute a major barrier to obtaining care. span：「Out-of-pocket costs for oral health care can be major barriers to accessing care.」 caveat：the original reads "can be", not 'necessarily are'; it is a global qualitative statement, not a quantified description of any one country.

F2｜S1｜confidence: high｜basis: official_statement｜geo: universal｜period: as F1 Paying for necessary oral health care is among the leading reasons for catastrophic health expenditures, and raises the risk of impoverishment and economic hardship. span：「Paying for necessary oral health care is among the leading reasons for catastrophic health expenditures, resulting in an increased risk of impoverishment and economic hardship.」 caveat：the original reads "among the leading reasons" (one of the leading reasons), and must not be inflated into the top-ranked reason.

F3｜S1｜confidence: high｜basis: official_statement｜geo: universal｜period: as F1 Unequal distribution of oral health professionals and a lack of appropriate facilities to meet population needs in most countries mean that access to primary oral health services is often low. span：「Unequal distribution of oral health professionals and a lack of appropriate health facilities to meet population needs in most countries means that access to primary oral health services is often low.」 caveat：a qualitative statement, with no country breakdown and no quantitative data attached.

F4｜S1｜confidence: high｜basis: official_statement｜geo: universal｜period: as F1 There is a very strong and consistent association between socioeconomic status (income, occupation and educational level) and the prevalence and severity of oral diseases; this association exists from early childhood to older age and across populations in high-, middle- and low-income countries. span：「There is a very strong and consistent association between socioeconomic status (income, occupation and educational level) and the prevalence and severity of oral diseases.」／「This association exists from early childhood to older age and across populations in high-, middle- and low-income countries.」 caveat：a statement of association, not proof of causation.

F5｜S1｜confidence: high｜basis: official_statement｜geo: universal｜period: as F1; the content refers to the 2021 WHA resolution The WHO fact sheet records that the 2021 WHA resolution affirms that oral health should be firmly embedded within the NCD agenda and that oral health-care interventions should be included in national universal health coverage benefit packages; the resolution also recommends a shift from the traditional curative approach towards a preventive approach. span：「The Resolution affirms that oral health should be firmly embedded within the NCD agenda and that oral health-care interventions should be included in national universal health coverage benefit packages.」／「The Resolution recommends a shift from the traditional curative approach towards a preventive approach」 caveat：this is a policy direction and a normative claim, not the present benefit position of any country; it must not be read as 'countries have already included it in their benefit packages'.

F6｜S3｜confidence: high｜basis: official_statement｜geo: universal｜period: WHA74.5, 2021-05-31 Item 1(7) of resolution WHA74.5 urges Member States to strengthen the provision of oral health services delivery as part of the essential health services package that delivers universal health coverage. span：「to strengthen the provision of oral health services delivery as part of the essential health services package that deliver universal health coverage」 caveat：this is a World Health Assembly resolution (an urging addressed to Member States), not the domestic law of any country, and must not be labelled at the law tier; the resolution is prefaced by 「URGES Member States, taking into account their national circumstances」, that is, it is premised on each country's own circumstances.

F7｜S3｜confidence: high｜basis: official_statement｜geo: universal｜period: as F6 Item 1(3) of resolution WHA74.5 urges Member States to reorient the traditional curative approach, which is basically pathogenic, and to move towards a preventive and promotional approach with risk identification for timely, comprehensive and inclusive care. span：「to reorient the traditional curative approach, which is basically pathogenic, and move towards a preventive promotional approach with risk identification for timely, comprehensive and inclusive care」 caveat：as F6.

F8｜S2｜confidence: medium｜basis: official_statement｜geo: universal｜period: published 2022-11-18 The WHO *Global oral health status report: towards universal health coverage for oral health by 2030* reviews the most recent data on major oral diseases, risk factors, health system challenges and opportunities for reform; and provides, as a separate online resource, the first-ever country oral health profiles for all 194 WHO Member States. span：「The WHO Global oral health status report reviews the most recent data on major oral diseases, risk factors, health system challenges and opportunities for reform.」／「the report provides, as a separate online resource, the first-ever country oral health profiles for all 194 WHO Member States」 caveat：only the publication landing page is cited; the 100-page full-text PDF was not downloaded. This article uses information only at the level of 'the existence of the report and the description of its scope', and cites no data from the body of the report.

F9｜S4｜confidence: medium｜basis: clinical_guideline｜geo: universal｜period: current version of the policy page (no explicit publication date shown) Position of the FDI World Dental Federation: UHC provides an opportunity to improve access to essential oral health services and to address substantial out-of-pocket expenses associated with oral healthcare in many countries; integrating essential oral health services into UHC will help improve health outcomes and reduce fundamental inequalities in access to care. span：「UHC provides a unique opportunity to improve access to essential oral health services and address substantial out-of-pocket expenses associated with oral healthcare in many countries」／「The integration of essential oral health services into UHC will help improve health outcomes and reduce fundamental inequalities in access to care.」 caveat：a policy position of an international professional organisation (including wording quoted from a WHO official), not the conclusion of an empirical study; the page shows no explicit publication date. In the source page the second span carries a space character before the final punctuation because of inline mark-up, and this was normalised for the comparison.

F10｜S4｜confidence: medium｜basis: clinical_guideline｜geo: universal｜period: as F9 The FDI page cites WHO's explanation that UHC does not mean free coverage for all possible health interventions regardless of the cost, because no country can provide all services free of charge on a sustainable basis. span：「UHC does not mean free coverage for all possible health interventions, regardless of the cost, as no country can provide all services free of charge on a sustainable basis」 caveat：this is the FDI page restating a WHO definition, not a direct quotation from an original WHO document.

F11｜S4｜confidence: medium｜basis: clinical_guideline｜geo: universal｜period: as F9 UHC is not only about ensuring a minimum package of health services; it is also about ensuring a progressive expansion of coverage of health services and financial protection as more resources become available. Nor is UHC just about health financing: it encompasses all components of the health system (health service delivery systems, the health workforce, health facilities and communications networks, health technologies, information systems, quality assurance mechanisms, and governance and legislation). Also recorded: like many other health services, basic oral healthcare remains out of reach for millions of people. span：「UHC is not only about ensuring a minimum package of health services, but also about ensuring a progressive expansion of coverage of health services and financial protection as more resources become available」／「UHC is not just about health financing. It encompasses all components of the health system: health service delivery systems, the health workforce, health facilities and communications networks, health technologies, information systems, quality assurance mechanisms, and governance and legislation」／「like many other health services, basic oral healthcare remains out of reach for millions of people」 caveat：as F10; 'millions of people' is a qualitative expression used on that page, with no statistical source or year attached. The Chinese rendering adopted for "quality assurance mechanisms" in the span was chosen to avoid a word form identical with a Class A prohibited term in the medical-advertising compliance lexicon (wording implying assurance of treatment outcomes), the same handling as F26's rendering of "the greatest barrier"; the verbatim basis is the span above.

F12｜S5｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: Int J Dent Hyg 2025;23(1):89-99 (Epub 2024-05-19), 35 articles included That critical review presented an operational guide for policy-making, mapped separately to three main models of healthcare systems: National Health Services, social/public health insurance, and private insurance. span：「An operational guide was finally presented for policy-making in each of the three main models of healthcare systems, including National Health Services, social/public health insurance and private insurance.」／「From a total of 142 articles/reports retrieved in PubMed, 73 in Scopus and 791 in Google Scholar, 35 were included in the final review after eliminating the duplicates and screening process.」 caveat：a critical review, not a systematic review or a meta-analysis; the three-way split is the policy-analysis framework adopted by that review, not an empirically tested taxonomy, and not the sole classification available. Real systems are mostly hybrids (see F16).

F13｜S5｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F12 That review identified ten mechanisms for cost control of dental care in total, placed under two headings, financing and service provision: 7 on the financing side (including cost sharing, preauthorization, mixed payment method, and an evidence-based approach to benefit package definition), and 3 on the service provision side (workforce skill mix with emphasis on primary oral healthcare providers, development of the primary healthcare network, and appropriate use of tele-dentistry). span：「Each mechanism was then classified and discussed under any of the two headings of financing and service provision.」／「Totally ten mechanisms were identified for CC of dental care. Seven were discussed under the financing function, including cost sharing, preauthorization, mixed payment method and an evidence-based approach to benefit package definition, among others.」／「Three further methods were classified under the service provision function, including workforce skill mix with emphasis on primary oral healthcare providers, development of primary healthcare (PHC) network and an appropriate use of tele-dentistry.」 caveat：the original's financing-side list ends with "among others" (further items exist that are not listed); the table in this article presents only the four items the original names, and makes no claim to be a complete list. This is a classification of policy-level mechanisms, not an explanation of the terms of any policy.

F14｜S5｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F12 Conclusion of that review: painless control of dental expenditures requires a smart integration of prevention into the cost-control plans. span：「Painless control of dental expenditures requires a smart integration of prevention into the CC plans.」 caveat：a policy recommendation by the authors, not an empirical result.

F15｜S6｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: BMC Oral Health 2025;25(1):1370; search from 2000-01 to 2024-09, 48 articles included The meta-analysis of socioeconomic status and dental service use among children and adolescents included 48 studies in total; children and adolescents of higher socioeconomic status were about twice as likely to use dental services as those of lower socioeconomic status (OR = 2.10, 95% CI 1.32–2.89). span：「we searched PubMed, Web of Science, and Scopus for relevant articles published between January 2000 and September 2024」／「A total of 48 studies met the inclusion criteria for this review.」／「children and adolescents from higher SES were about twice as likely to utilize dental services (OR = 2.10, 95% CI: 1.32-2.89) compared to those from lower SES backgrounds」 caveat：restricted to children and adolescents, and not extrapolable to adults; an association, not causation.

F16｜S6｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F15 The type of dental insurance system influenced the size of the above association: universal coverage OR 1.73 (95% CI 1.19–2.26), means-tested systems OR 1.70 (95% CI 1.40–2.00), mixed public-private systems OR 1.47 (95% CI 1.09–1.85). span：「The type of dental insurance system also influenced the outcomes, with significant associations found in countries with universal coverage (OR = 1.73, 95% CI: 1.19-2.26), means-tested systems (OR = 1.70, 95% CI: 1.40-2.00), and mixed public-private systems (OR = 1.47, 95% CI: 1.09-1.85).」 caveat：the three confidence intervals overlap one another, and cannot be used to rank the systems or to claim that any one of them performs better; this is a subgroup analysis, with lower statistical power than the main analysis.

F17｜S7｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: BMC Oral Health 2025;26(1):289; 4,226 screened down to 233 articles, 49 countries The cross-country systematic review screened 4,226 publications in multiple stages down to 233 articles (qualitative 42, quantitative 177, mixed-methods 14), with data collection spanning 49 countries; it identified 101 factors influencing patients' treatment choice, divided into three categories: dentist and dental institution (for example communication), patient (for example dental fear), and treatment (for example durability). span：「After multistage screening of N = 4,226 publications by two reviewers, N = 233 relevant articles of different study designs (qualitative (N = 42), quantitative (N = 177), and mixed-methods (N = 14)) were included in the analysis.」／「approaches (e.g., interviews) in 49 countries」／「various factors of choice (n = 101) were identified, divided into three categories: (I) "Dentist & dental institution" (e.g., communication), (II) "Patient" (e.g., dental fear), and (III) "Treatment" (e.g., durability).」 caveat：the original states of itself that "The quality of the included studies varied considerably."; it is a narrative synthesis (SWiM), with no meta-analysis performed.

F18｜S7｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F17 Among the 233 articles included, out-of-pocket payment and dental fear ranked highest both for the number of articles in which they appeared and for how often they were mentioned: found in 136 and 64 articles respectively, with coded mention frequencies of 151 and 73.

• span: "After multistage screening of N = 4,226 publications by two reviewers, N = 233 relevant articles of different study designs (qualitative (N = 42), quantitative (N = 177), and mixed-methods (N = 14)) were included in the analysis."

span：「The factors 'out-of-pocket payment' and 'dental fear' were identified in most of the articles (N = 136, N = 64) and were mentioned most frequently (code frequencies: n = 151, n = 73).」 caveat：this is the frequency of mention within the literature, not the actual prevalence of that factor in a patient population; the two must not be interchanged.

F19｜S7｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F17 In the countries with the most articles, out-of-pocket payment was likewise a frequently identified factor — for example, mentioned in 56% of the UK articles and 68% of the Indian ones. span：「In countries with the most articles (e.g., the UK (N = 28), Saudi Arabia (N = 23), the USA (N = 22), India (N = 19), and Brazil (N = 14)), also 'out-of-pocket payment' was identified most often (e.g., the UK: in 56% of the articles; India: 68%).」 caveat：the denominator is the number of articles included from that country (UK 28, India 19), not the number of patients in that country; the sample base is small, and these must not be treated as country-representative values.

F20｜S8｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: Community Dent Oral Epidemiol 2026;54(4):392-406; PRISMA 2020, 2600 screened down to 25 articles, covering 2000 to 2026-03 The systematic review of the economic burden of preventable dental-related emergency department visits (PDEDV) and hospital admissions (PDHA) included 25 articles in total; uninsured individuals, public health insurance enrolees and residents of low-income areas were more likely to experience PDEDV. span：「for studies reporting direct and/or indirect costs of PDEDV and PDHA in any age group, published in English from 2000 to March 2026」／「Of the 2600 total studies identified, 25 met the inclusion criteria.」／「Uninsured individuals, public health insurance enrolees and residents of low-income areas were more likely to experience PDEDV.」 caveat：the original states of itself that most of the included studies were conducted in the United States and focused on direct medical costs, so extrapolation across systems requires caution.

F21｜S8｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F20 PDEDV and PDHA were primarily driven by financial barriers, socio-demographic disparities, limited access to routine dental care and health workforce constraints; dental caries was the most frequently occurring cause of PDEDV (the original wording is commonest cause). The original inflation-adjusted the costs of the included studies and standardised them to 2024 US dollars before reporting ranges. span：「PDEDV and PDHA were primarily driven by financial barriers, socio-demographic disparities, limited access to routine dental care, and health workforce constraints.」／「Dental caries was the commonest cause for PDEDV.」／「Charges/costs were inflation-adjusted and standardised to 2024 US dollars.」 caveat：the cost-range figures in the original are not reproduced here, under this line's editorial rules (reporting actual prices is prohibited); this article cites only its structure of drivers and its standardisation method.

F22｜S9｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: BMC Oral Health 2025;25(1):227; searched up to 2023-10, 45 articles included The systematic review of willingness to pay (WTP) for dental services included 45 articles in total; mean WTP varied widely and was influenced by demographic factors (age, gender), socioeconomic conditions, insurance cover and perceived need for dental care. span：「Original studies on the preference and WTP for dental services published up to October 2023 were considered.」／「A total of 45 articles were eligible for inclusion, indicating that WTP research was primarily based on convenience and non-probabilistic sampling.」／「Mean WTP showed significant variation and was influenced by demographic factors (age, gender), socioeconomic conditions, insurance cover, and perceived need for dental care.」 caveat：the original states of itself that the research was mostly convenience and non-probabilistic sampling, so the results describe the samples and not a population; subjects were restricted to those aged 18 and over.

F23｜S9｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F22 The main attributes that review identified from the studies fall into four classes: cost (out-of-pocket payment, price), service delivery, time, and treatment outcome. span：「The main attributes identified from the studies related to cost (out of pocket payment, price), service delivery, time, and treatment outcome.」 caveat：this is the classification of attributes used in WTP research; this article treats it as a framework for understanding where cost variation comes from, and it is not an itemisation rule for any charge.

F24｜S10｜confidence: medium｜basis: peer_reviewed｜geo: universal (methodological layer) / single country (numerical layer)｜period: J Oral Biol Craniofac Res 2026;16(2):101402; JBI + PRISMA 2020, PROSPERO ID CRD420251030651, 1684 screened down to 15 articles In that systematic review of the economic burden of oral diseases in one country: the prevalence of catastrophic health expenditure (CHE) ranged from 0.6% to 96% depending on the definition, while pooling only the studies using the threshold of expenditure at or above 20% of income gave 18.8%; insurance coverage was below 15% with limited protection; and up to one-third of patients relied on hardship financing (borrowing or selling assets). span：「Of 1684 records, 15 met inclusion criteria, mostly cross-sectional across states.」／「The protocol is prospectively registered in the International Prospective Register of Systematic Reviews database (PROSPERO ID: CRD420251030651).」／「CHE ranged from 0.6 % to 96 % across definitions; pooling studies using the ≥20 % income threshold yielded a CHE prevalence of 18.8 %.」／「Insurance coverage was low (<15 %) with limited protection.」／「Up to one-third of patients relied on hardship financing (borrowing or asset sales).」 caveat：the numerical layer is restricted to a single country (India) and must not be extrapolated to other countries; the included studies were mostly cross-sectional and spread across states. The main purpose for which this article uses this unit is to display the methodological phenomenon that differing definitions make one and the same indicator swing enormously.

F25｜S10｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F24 The priorities listed by that review include stronger national data, standardised costing and reporting (price year, components, variance), and expanded financial protection.

• span: "Of 1684 records, 15 met inclusion criteria, mostly cross-sectional across states."

span：「Priorities include stronger national data, standardised costing/reporting (price year, components, variance), and expanded financial protection to reduce household hardship and advance universal oral health coverage.」 caveat：a policy recommendation by the authors; this article translates 'price year / components / variance' into a checking framework at the reader's end, and that translation is an educational application made here, not the object the original was addressing.

F26｜S11｜confidence: medium｜basis: peer_reviewed｜geo: universal (as a paradigm of institutional gaps) / single country (numerical layer)｜period: Health Policy 2025;158:105359; search from 1999 to 2025-04-10, 37 articles included The systematic review of the qualitative literature on out-of-pocket costs among people with chronic conditions in Australia included 37 articles in total; despite that country's universal health insurance scheme, Medicare, out-of-pocket costs for health care still comprise 14% of total health expenditure; the review records that cost was the foremost barrier to obtaining dental care (the original wording is the greatest barrier), and records trade-offs described by respondents between health management and meeting basic living needs, particularly among people who earned too much to qualify for government welfare payments. span：「Search: Pubmed, CINAHL Complete, Cochrane Library, PsycINFO and EconLit databases from 1999 to 10th April 2025.」／「Despite Australia's universal health insurance scheme, Medicare, out-of-pocket costs (OOPC) for health care comprises 14 % of total health expenditure.」／「37 studies met the inclusion criteria.」／「Cost was the greatest barrier to accessing dental care.」／「Trade-offs were described between health management and meeting basic living needs, particularly for people who earned too much to qualify for government welfare payments.」 caveat：the numerical layer is restricted to a single country (Australia) and must not be extrapolated; the subjects were people with chronic conditions and their families, not the general population; it is a narrative synthesis of qualitative literature. The body text and this column consistently render the phrase as 'the foremost barrier' so as to avoid superlative wording; the original wording is "the greatest barrier", and the verbatim basis is the span above.

F27｜S12｜confidence: medium｜basis: peer_reviewed｜geo: universal (framework layer) / single country (evidence layer)｜period: BMC Health Serv Res 2025;25(1):988; 1126 screened down to 15 articles Systematic review conducted with the Andersen behavioural model of health services use: income level, insurance coverage and facility availability are enablers; sociodemographic characteristics, fear and anxiety, and a negative past experience are predisposing factors; perception of one's own oral health status and the absence or presence of poor oral health symptoms are need factors. span：「From 1126 studies, results were drawn from final 15 studies.」／「Income level, insurance coverage, and facility availability were found as enablers of dental service utilization.」／「Sociodemographic characteristics, fear and anxiety, and a negative past experience were identified as predisposing factors.」／「Perception of one's oral health status, and absence/presence of poor oral health symptoms were identified as need factors.」 caveat：the evidence layer is restricted to a single country (India); what this article cites is the classification of factors under the Andersen model, an international standard analytical framework in public health, and it does not extrapolate that country's prevalence figures or proportions.

F28｜S13｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: Cochrane Database Syst Rev 2026;7(7):CD016279; searched 2025-04, 14 reviews / 57 primary studies Direct-placement dental restorative materials serve to replace lost tooth substance and restore the functional structural integrity of damaged posterior teeth; the overview included 14 reviews covering 57 primary studies, of which only about 10% were conducted in general practice settings. span：「In April 2025, we searched the Cochrane Library, MEDLINE, Embase, Epistemonikos and PROSPERO for systematic reviews」／「Direct-placement dental restorative materials are required to replace the loss of tooth substance and restore the functional structural integrity of damaged posterior teeth.」／「Overall, we found 14 reviews including 57 primary studies; only one was a Cochrane review. Very few primary studies (about 10%) were conducted in general practice.」 caveat：only about 10% of the primary studies came from general practice settings, so extrapolation to everyday outpatient care must be qualified. This article deliberately cites no figure from that overview comparing the effectiveness of one material against another, because this is a systems-level article and gives no clinical advice on material selection.

F29｜S13｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F28 The six economic reports identified by that overview produced no strong conclusions regarding the cost-effectiveness of mercury-free restorative materials. span：「Six economic reports identified no strong conclusions regarding the cost-effectiveness of mercury-free restorative materials.」 caveat：a statement about a gap in the economic evidence; it must not be read in reverse as 'a given material is less cost-effective'.

F30｜S13｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F28 Recommendation of that overview: the results of clinical effectiveness should be considered alongside cost, acceptability, clinical presentation, the time required for restoration placement (which may be technique-sensitive), and the health and environmental considerations of the materials. span：「The results of clinical effectiveness should be considered alongside cost, acceptability, clinical presentation, time required for restoration placement (which may be technique-sensitive), and the health and environmental considerations of the materials.」 caveat：a recommendation addressed to policy and clinical practice, not an instruction to patients on selecting materials; material selection must be judged by a dentist in the light of the individual situation.

F31｜S13｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F28 The conclusions of that overview emphasise that caries prevention is critical to effective and sustainable oral health. span：「These conclusions emphasise that caries prevention is critical to effective and sustainable oral health.」 caveat：a concluding statement by the authors.

F32｜S14｜confidence: low｜basis: peer_reviewed｜geo: universal｜period: Oper Dent 2026;50(5):477-490; searched up to 2025-04, 7 systematic reviews included Umbrella review of the repair of resin composite restorations: a meta-analysis found no significant difference in failure rates between repair and replacement (RR = 1.21, 95% CI 0.51–2.83), though the certainty of the evidence was low; standardised decision-making tools were lacking. span：「A comprehensive search was conducted in five databases up to April 2025.」／「Seven systematic reviews were included.」／「A meta-analysis found no significant difference in failure rates between repaired and replaced restorations (RR= 1.21; 95% CI: 0.51-2.83), though evidence certainty was low.」／「Standardized decision-making tools were lacking.」 caveat：the certainty of the evidence is low and the confidence interval crosses 1, so this is 'no difference detected' rather than 'no difference demonstrated'; it is restricted to the situation of repairing resin composite restorations, and cannot be extrapolated to repair-versus-replacement decisions for other procedures.

F33｜S14｜confidence: low｜basis: peer_reviewed｜geo: universal｜period: as F32 Surveys reported high patient acceptance of repair (greater than 86%) and professional endorsement of repair, yet in practice only 31.3% of defective restorations were repaired; the authors hold that broader implementation still requires guideline standardisation, clinical training, and studies incorporating patient-reported outcomes and cost-effectiveness. span：「Surveys reported high patient acceptance (> 86%) and professional endorsement of repair, yet only 31.3% of defective restorations were repaired.」／「Broader implementation requires guideline standardization, clinical training, and studies incorporating patient-reported outcomes and cost-effectiveness.」 caveat：the figures come from survey studies synthesised by the umbrella review, not from randomised controlled trials; the regions and time span of those surveys are not stated, and they must not be treated as a global prevalence.

F34｜S15｜confidence: low｜basis: peer_reviewed｜geo: universal｜period: Mil Med 2025;190(7-8):e1679-e1685; the data come from a stratified cross-sectional study of 2018 The pilot study used data from a 2018 stratified cross-sectional study of 1,208 randomly selected U.S. Air Force recruits to compare the treatment-planning decisions of two provider groups (2 civilian, 7 military); for both patient-level and tooth-level data, statistically significant differences were found between the treatment-planning decisions of the two groups (P < .05). span：「Patient-level data from the 2018 Recruit Surveillance, a stratified, cross-sectional study of 1,208 randomly selected U.S. Air Force recruits, were used to evaluate treatment planning outcomes for the 2 provider groups (2 civilians; seven military providers).」／「Significant differences were found between military and civilian dentists' treatment planning decisions (P < .05) for both patient-level and tooth-level data.」 caveat：a pilot study, with a very small number of providers (2 against 7), in the setting of a military recruit examination rather than ordinary outpatient practice; it can support only the existence statement that treatment-planning decisions vary between providers, and must not be extrapolated into 'patients will be given different quotations at different clinics', nor read as over-treatment or under-treatment on either side. This article cites no direction of between-group comparison for any specific treatment item in that study.

F35｜S15｜confidence: low｜basis: peer_reviewed｜geo: universal｜period: as F34 Conclusion of the authors of that study: comparisons of treatment planning outcomes between civilian and military providers warrant further research. span：「Therefore, comparisons of treatment planning outcomes between civilian and military providers warrant further research.」 caveat：the authors state that the evidence is insufficient for a conclusion, and on that basis this article makes an existence statement only.

10. Compliance notes

• This article is a compilation of health education and new medical knowledge. It is a plain transmission of health education and medical information, involves no solicitation of patients, and does not constitute medical advertising, nor diagnosis, treatment, insurance or legal advice.
• This article presents no monetary amount, no currency, no cost range and no charging information; monetary values appearing in the cited literature are not reproduced. Nor does this article compare or recommend any healthcare institution, or offer advice on bargaining.
• This article explains no individual insurance policy. Whether policy terms apply and whether a claim is paid are governed by the wording of the insurance contract, by the determination of the underwriting body, and by the rules of the competent authority of the place concerned; where a dispute arises, use the formal complaint channels of that place.
• All the data in this article are group-level research results and system-level statistics from international literature, and cannot be used to estimate the individual outcome or the individual cost of any one patient; the actual treatment method and its effect vary from person to person, and must be assessed by a dentist in the light of the individual situation.
• This article is a systems-level domain article. It does not describe or promote any specific course of treatment; for the indications, possible side effects and contraindications of each procedure, see the corresponding procedure domain articles and canonical cards, and be assessed by a dentist.
• Do not postpone care on your own because of concerns about cost: the literature records that limited access to routine dental care and financial barriers are the main drivers of preventable dental-related emergency visits and admissions [F21]. If pain, swelling, fever or other acute symptoms appear, seek care promptly and be assessed by a dentist.
• The geo_scope of this article is global: it does not deal with the insurance benefits, charging rules or medical regulations of any country; for the local system, see the corresponding TW canonical card.
• Status: draft; the publication gate has not been passed; the four language versions are not yet complete; awaiting OP's own verification and the owner's final review.

11. Source list

Access date for all entries: 2026-08-06 (Taipei time). Method of retrieval: direct curl of the official websites (WHO / WHA / FDI) and NCBI E-utilities efetch (PubMed); every one measured at HTTP 200, with the spans compared verbatim by program.

basis tally: official_statement 3 / clinical_guideline 1 / peer_reviewed 11 / total 15 (peer_reviewed ≥6 threshold met; whole-article sources ≥8 threshold met).

The law tier is honestly left empty: under the 2026-08-06 revision of PILLAR-SPEC.md, this whole line is set as global, and Taiwanese regulations, national health insurance material and health-bureau material must not serve as a basis. Within the international system, apart from WHA74.5 (already listed as official_statement, and not domestically binding law in any country), no applicable supranational mandatory regulation was found that could be placed at the law tier; the law tier therefore holds 0 items, with nothing forced in and no over-grading of the label. The specific Taiwanese legal basis is carried by the corresponding TW canonical cards, and this article only points the way with downstream-link sentences.

Anchor-file items not adopted: none. All 12 international sources in the P12 anchor file were adopted (S1–S12), with 3 further sources added (S13–S15, see the next section).