IADR Abstract Archives
Cost-effectiveness of fissure sealants versus fluoride varnish in preventing dental caries
Objectives: This work presents an economic analysis of a randomised controlled trial on the relative effectiveness of fissure sealants and fluoride varnish in the prevention of dental caries.
Methods: Setting: mobile dental clinics in schools located in deprived communities. Participants: 1016 children, aged 6-7 years at baseline, randomised 1:1 to receive either fissure sealants or fluoride varnish. Interventions: resin-based fissure sealants were applied to caries-freefirst permanent molars and maintained at six monthly intervals. Fluoride varnish was applied at baseline and at six month intervals. Caries outcome was determined at 36 months. Health economic analysis: the costs associated with the interventions were summarised into the following categories; costs of the interventions; health care utilisation costs associated with travel or caregiving/time of work for families; costs associated with the schools. The CHU-9D (a child-specific generic preference based measure of health related quality of life) was used to generate utility values for each health state to enable the calculation of QALYs.
Results: At 36 months 835 (82%) children remained. A smaller proportion of children who received FV (73[17.5%]) developed caries into dentine on a least one FPM compared with FS (82 [19.6%]) OR = 0.84 (CI 0.59 to 1.21) [p = 0.35]. Costs showed small, but statistically significant differences between arms; NHS costs of FS vs. FV was £500 vs. £432 with a mean difference of £68.13 (95% CI 5.63-130.63, p= 0.033) in favour of FV.
Conclusions: In a community oral health programme utilising mobile dental clinics and targeted at children with high caries risk, twice yearly application of fluoride varnish resulted in caries prevention which is not significantly different from that obtained by applying and maintaining fissure sealants after 36 months. Fluoride varnish proved less expensive than fissure sealant.
Registration: EudraCT No: 2010-023476-23 ISRCTN ref: ISRCTN17029222
Funding: This work was funded by the UK NIHR Ref: 08/08/104/04.
Methods: Setting: mobile dental clinics in schools located in deprived communities. Participants: 1016 children, aged 6-7 years at baseline, randomised 1:1 to receive either fissure sealants or fluoride varnish. Interventions: resin-based fissure sealants were applied to caries-freefirst permanent molars and maintained at six monthly intervals. Fluoride varnish was applied at baseline and at six month intervals. Caries outcome was determined at 36 months. Health economic analysis: the costs associated with the interventions were summarised into the following categories; costs of the interventions; health care utilisation costs associated with travel or caregiving/time of work for families; costs associated with the schools. The CHU-9D (a child-specific generic preference based measure of health related quality of life) was used to generate utility values for each health state to enable the calculation of QALYs.
Results: At 36 months 835 (82%) children remained. A smaller proportion of children who received FV (73[17.5%]) developed caries into dentine on a least one FPM compared with FS (82 [19.6%]) OR = 0.84 (CI 0.59 to 1.21) [p = 0.35]. Costs showed small, but statistically significant differences between arms; NHS costs of FS vs. FV was £500 vs. £432 with a mean difference of £68.13 (95% CI 5.63-130.63, p= 0.033) in favour of FV.
Conclusions: In a community oral health programme utilising mobile dental clinics and targeted at children with high caries risk, twice yearly application of fluoride varnish resulted in caries prevention which is not significantly different from that obtained by applying and maintaining fissure sealants after 36 months. Fluoride varnish proved less expensive than fissure sealant.
Registration: EudraCT No: 2010-023476-23 ISRCTN ref: ISRCTN17029222
Funding: This work was funded by the UK NIHR Ref: 08/08/104/04.