title: Caries and costs: an evaluation of a school-based fluoride varnish programme for adolescents in a Swedish region.
abstract: In 2003, 19 public dental clinics in Västra Götaland Region implemented a population-based programme with fluoride varnish applications at school every six months, for all 12 to 15 year olds. In 2008, the programme was extended to include all 112 clinics in the region.
  
  
  OBJECTIVE
  To evaluate caries increment and to perform a cost analysis of the programme.
  
  
  METHODS
  A retrospective design with caries data for two birth cohorts extracted from dental records. Three groups of adolescents were compared. For Group 1 (n = 3,132), born in 1993, the fluoride varnish programme started in 2003 and Group 2 (n = 13,490), also born in 1993, had no fluoride varnish programme at school. These groups were compared with Group 3 (n = 11,321), born in 1998, when the programme was implemented for all individuals. The total cost of the four-year programme was estimated at 400SEK (≈ 44€) per adolescent.
  
  
  RESULTS
  Caries prevalence and caries increment in 15 year olds were significantly lower after the implementation of the programme. Group 2, without a programme, had the highest caries increment. The cost analysis showed that it was a break-even between costs and gains due to prevented fillings at the age of 15.
  
  
  CONCLUSIONS
  This school-based fluoride varnish programme, implemented on a broad scale for all 12 to 15 year olds, contributed to a low caries increment at a low cost for the adolescents in the Västra Götaland Region in Sweden.
authors.forename: E K
authors.initials: EK
authors.lastname: Bergström
authors.forename: P
authors.initials: P
authors.lastname: Lingström
authors.forename: M
authors.initials: M
authors.lastname: Hakeberg
authors.forename: L
authors.initials: L
authors.lastname: Gahnberg
authors.forename: U M
authors.initials: UM
authors.lastname: Sköld
mesh_terms: D000293:Adolescent; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D017046:Cost Savings; D003365:Costs and Cost Analysis; D004245:DMF Index; D019140:Dental Care for Children / Q000706:statistics & numerical data; D003731:Dental Caries / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003793:Dental Restoration, Permanent / Q000191:economics; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006267:Health Education, Dental / Q000191:economics; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012571:School Dentistry / Q000191:economics*; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D002327:Cariostatic Agents; D005460:Fluorides, Topical