Cost-Effectiveness of Pit-and-Fissure Sealants on Primary Molars in Medicaid-Enrolled Children

Donald, L.; Goes, David N. van der; Ney, John P.

doi:10.2105/ajph.2013.301588

Cited by 36 publications

(43 citation statements)

References 31 publications

(3 reference statements)

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“…Sealants have also been used to seal occlusal surfaces of primary molar teeth, and a cost-effectiveness analysis of this treatment has been shown to reduce subsequent dental costs [Chi et al, 2014]. Furthermore, dental sealants provide protection against the development of dental caries when applied to pits and fissures, though there is no evidence that sealants have a beneficial indirect effect on caries development elsewhere in the dentition.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Dental Sealants versus Fluoride Varnish in a School-Based Setting

Neidell

Shearer²,

Lamster

2016

Caries Res

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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.

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Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Dental Sealants versus Fluoride Varnish in a School-Based Setting

Neidell

Shearer²,

Lamster

2016

Caries Res

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“…Chi et al compared the cost‐effectiveness of three primary molar sealant delivery strategies: (i) “always seal” or AS (same as described in Ney et al), (ii) “standard care” or SC (same as described in Ney et al) and (iii) “never seal” or NS. The authors noted that the SC strategy might actually employ a “selectively seal” strategy, where the highest risk primary molars are assumed to be sealed and suggested future testing of this assumption.…”

Section: Resultsmentioning

confidence: 99%

Economic evaluation of dental sealants: A systematic literature review

Akinlotan

Chen²,

Fontanilla

et al. 2017

Comm Dent Oral Epid

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Objectives: To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants.Methods: Of 21 full-text articles examined, a total of 13 were included in this study. These studies are grouped by the type of intervention as follows: (i) sealants compared with no sealants; (ii) sealants compared with other forms of caries prevention; (iii) resin-based sealants compared with glass-ionomer sealants; (iv) different sealing strategies in primary teeth; (v) different sealing strategies in permanent teeth; and (vi) sealants based on school-or clinic-based setting of delivery. All currency is reported in constant 2010 US$.Results: Cost-effectiveness analyses differed due to varying study designs, assumptions, sealant delivery settings, outcomes, caries risk assessment and study durations.Findings varied on the cost-effectiveness of sealants compared with other caries-preventive strategies. Under the assumption of equal caries risk, always sealing primary molars appeared to be the most effective strategy, whereas risk-based sealing was the optimal strategy with differing caries risk. Studies that assessed sealing strategies in permanent teeth reported that risk-based sealing was more cost-effective than not sealing, but they differed on the cost-effectiveness of risk-based seal compared with non-risk-based seal. Sealants delivered in school settings had mixed results on costs but were as equally effective as sealants delivered in private practices. Conclusions:The cost-effectiveness of sealants is dependent on the conditions of delivery. The list of cost-effectiveness ratios for each intervention can support policy makers to estimate expected returns on their investments in dental sealants. States in 2014. 5 Interventions involving the delivery of dental sealants on a large scale have been limited due to uncertainty on their cost-effectiveness, as there are concerns that treating dental decay is cheaper than using sealants. economic evaluations in dentistry means that there has been a growing number of reviews which examine the scientific literature on the cost and effectiveness of dental caries prevention programmes more generally.12,13The current study builds on this scientific literature by focusing specifically on economic evaluation of dental sealants for caries prevention. The primary objective of this study was to review the literature on costs and benefits of using dental sealants to prevent caries. 2 | ME TH ODS 2.1 | Search strategy and data collectionTo identify articles published on the economic evaluation of dental sealants, we searched PubMed, MEDLINE (via EBSCOhost) and CINAHL (via EBSCOhost) databases using search terms such as "dental sealants," "pit and fissure sealants," "cost," "cost analysis,""cost-benefit analysis," "cost allocation," "direct service costs" and "economics" (see Table 1 for complete search terms). Only English language articles published in peer-reviewed journals from 1996 through Octob...

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“…One way to achieve this goal is to provide additional preventive benefits for CSHCN, which gives dentists additional opportunities to assess changes in risk, monitor disease, and use appropriate preventive care strategies, including sealants on primary molars, fluoride varnish, and silver diamine fluoride. 33-34 Caregivers would also have opportunities to ask questions and identify strategies to improve home-based oral health behaviors. Increased exposure to the dental environment could also help to desensitize children and ease future dental visits.…”

Section: Discussionmentioning

confidence: 99%

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

Craig¹,

Scott²,

Slayton³

et al. 2019

The Journal of the American Dental Association

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Background. Low-income, preschool-aged children with special health care needs (CSHCN) are at increased risk for poor oral health. The study goal was to assess preventive dental care use for Medicaid-enrolled CSHCN within Washington state’s Access to Baby and Child Dentistry (ABCD) Program. Methods. We analyzed 2012 Medicaid eligibility and claims files for children under age 6 years in the ABCD Program (N=206,488). Medical diagnosis and eligibility data were used to identify each child’s special needs status (no/yes). The outcome was preventive dental care use (no/yes). Modified Poisson regression models were used to estimate crude and covariate-adjusted prevalence rate ratios (PRR). Results. Of the 206,488 children in the study, 2.1% were CSHCN and 114,570 utilized preventive dental care (55.5%). CSHCN utilized preventive care at similar rates compared to children without SHCN (54.7% and 55.5%, respectively; P=0.32). After adjusting for confounders, CSHCN were significantly less likely to utilize preventive dental care than children without SHCN (PRR: 0.91; 95% CI: 0.88, 0.94; P<0.001). Older preschoolers were significantly more likely to use preventive dental care than younger preschoolers. A significantly higher proportion of preventive medical care utilizers also utilized preventive dental care. Conclusions. Medicaid-enrolled CSHCN in Washington’s ABCD Program were less likely to utilize preventive dental care than Medicaid-enrolled children without SHCN. Practical Implications. Future intervention research should evaluate strategies to improve access to preventive dental care for CSHCN. Additional strategies may be needed to improve oral health behaviors for preschool-aged CSHCN in Medicaid.

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Cost-Effectiveness of Pit-and-Fissure Sealants on Primary Molars in Medicaid-Enrolled Children

Cited by 36 publications

References 31 publications

Cost-Effectiveness Analysis of Dental Sealants versus Fluoride Varnish in a School-Based Setting

Cost-Effectiveness Analysis of Dental Sealants versus Fluoride Varnish in a School-Based Setting

Economic evaluation of dental sealants: A systematic literature review

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

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