Cost-Effectiveness Analysis of Dental Sealants versus Fluoride Varnish in a School-Based Setting.
While sealants are more effective than fluoride varnish in reducing the development of new carious lesions on occlusal surfaces, and a course of treatment requires fewer clinical visits, they are more expensive per application. This analysis assessed which treatment is more cost-effective. We estimate the costs of sealants and fluoride varnish over a 4-year period in a school-based setting, and compare this to existing estimates of the relative benefits in terms of caries reduction to calculate the relative cost-effectiveness of these two preventive treatments. In our base case scenario, varnish is more cost-effective in preventing caries. Allowing for caries benefits to nonocclusal surfaces further improves the cost-effectiveness of varnish. Although we found that varnish is more cost-effective, the results are context specific. Sealants become equally cost-effective if a dental hygienist applies the sealants instead of a dentist, while varnish becomes increasingly cost-effective when making comparisons outside of a traditional dental clinic setting.
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, N.Y., USA.
Matthew
M
Neidell
Barbara
B
Shearer
Ira B
IB
Lamster
D002648:Child; D003362:Cost-Benefit Analysis; D003731:Dental Caries / Q000517:prevention & control*; D005460:Fluorides, Topical / Q000008:administration & dosage / Q000191:economics*; D006801:Humans; D009909:Oral Health / Q000191:economics; D010895:Pit and Fissure Sealants / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D012571:School Dentistry / Q000191:economics*; D016896:Treatment Outcome; D014481:United States
D005460:Fluorides, Topical; D010895:Pit and Fissure Sealants