Desmopressin is much more expensive but no more effective than imipramine. Other commonly used forms of management such as star charts and rewards, fluid deprivation and lifting have not been reliably evaluated. There is a large choice of materials that can be used for fillings. Many are introduced into the market place and used on patients with very limited evidence that they are more effective or efficient than existing materials. This has created high levels of uncertainty about the merits of different materials currently in use.
Dental amalgam is the material of choice unless aesthetics are very important.
It lasts longest and is the cheapest. The life span of fillings achieved in better quality research studies suggests that routine clinical practice may be producing sub-optimal results. Work is needed to establish means of improving the quality of routine practice, putting in place incentives to promote cost-effective care and identifying the resource implications. The research found that whilst nearly all of the women who received each leaflet reported that it was helpful or very helpful, there was no evidence that the leaflets were effective in increasing the proportion of women who reported having exercised informed choice. Informed choice' was simply equated with having the leaflets.