Pit-and-fissure sealants on primary molars are a cost savings

Halasa‐Rappel, Yara A.; Archibald, J.; Miller, Paulina; Lambert, R. Frederick; Hong, Michael; Ng, Man Wai; Sulyanto, Rosalyn

doi:10.1016/j.adaj.2021.05.005

Cited by 3 publications

(15 citation statements)

References 11 publications

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“…Research conducted in the USA also analyzed the costeffectiveness of sealed versus non-sealed from both the payer perspective and the societal perspective. The results showed that the cost-effectiveness of the social perspective was better than that of the payer perspective, which is consistent with our findings [Halasa-Rappel et al, 2021]. From the societal perspective, the time cost of the parents accompanying children for treatment is considered, among which the cost saved by avoiding the absence from work due to the application of PFS to avoid dental caries is the benefit.…”

Section: Discussionsupporting

confidence: 88%

“…Studies that have examined the economics of PFS application have focused on high-income countries and regions, such as the USA [Zabos et al, 2002;Chi et al, 2014;Neidell et al, 2016] and Europe [Werner et al, 2000;Humphreys et al, 2017]. Studies generated Markov models [Quiñonez et al, 2005;Bertrand et al, 2011;Espinoza-Espinoza et al, 2019] and decision tree models [Halasa-Rappel et al, 2021] to focus on the costs and effects of PFS application on children's permanent molars. Cost-effectiveness analysis is mostly used, and fewer studies have conducted cost-benefit analysis [Lai et al, 2020] and cost-utility analysis [Bhuridej et al, 2007;Espinoza-Espinoza et al, 2019].…”

Section: Introductionmentioning

confidence: 99%

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Cost-Effectiveness of Pit and Fissure Sealing at Schools for Caries Prevention in China: A Markov Modeling Analysis

Zhou¹,

Li²,

Liu³

et al. 2023

Caries Res

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The World Health Organization states that the application of pit and fissure sealants (PFS) is an effective way to prevent dental caries. Estimates of potential health and economic impacts of PFS upon school-age children provide crucial evidence to support the extension of PFS coverage to all target populations. The China Children's Oral Disease Comprehensive Intervention Project was launched in 2009 to provide free oral health examinations, PFS application, and oral health education for children aged seven to nine years. However, the national-level health and economic impacts of the program are unclear. To provide higher-quality evidence at the national level in China, we developed a multi-perspective, multi-state Markov model to estimate the cost and effect of PFS application to prevent dental caries. The total cost of the PFS project was 2.087 billion CNY, which can prevent 16.06 million PFMs from caries lesions. Compared with no intervention, PFS application was cost-effective from payer and society perspectives (BCR=1.22 from the payer’s perspective, BCR=1.91 from the societal perspective). The incremental cost-effectiveness ratio (ICER) from both perspectives was negative (-61.46 CNY from the payer's perspective, and -125.75 CNY from the societal perspective), indicating that PFS was cost-effective and cost-saving. Expanding the coverage of PFS application in school can be a more cost-effective strategy for caries prevention in China.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Pit and Fissure Sealing at Schools for Caries Prevention in China: A Markov Modeling Analysis

Zhou¹,

Li²,

Liu³

et al. 2023

Caries Res

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“…While the articles [34,49] were about similar results, the articles [43,48] represented the baseline study [43] and the follow-up study with final clinical trial results [48]. Of the 24 articles included in the systematic review, 17 articles could be classified as prevention [18,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]49]. Seven studies were classified as restoration [42][43][44][45][46][47][48].…”

Section: Resultsmentioning

confidence: 99%

“…All included studies were published in the last decade [18,. Most of the included articles (12 studies) and thus half of the articles were published in the last 3 years from 2020 to 2023 [18,[33][34][35][36][37][38][39][40][41]48,49].…”

Section: Resultsmentioning

confidence: 99%

“…Studies were classified chronologically according to their country of study conduct, number of study participants, location (e.g., practice/clinic) of study conduct, age of study participants, and study quality assessment. Furthermore, included studies were classified into two main groups of prevention according to their primary outcome [18,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and restoration [42][43][44][45][46][47][48] with different subgroups divided at prevention (outreach/education/education, sealing, fluoride varnish, and silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) as well as restoration (filling and crown). For ease of synthesis and clarity, the results were summarized in tables.…”

Section: Data Sources Search Strategy and Study Selectionmentioning

confidence: 99%

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Cost-Effectiveness of Treatment Decisions for Early Childhood Caries in Infants and Toddlers: A Systematic Review

Wolf,

Campus

2023

Medicina

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Background and Objectives: Early childhood caries (ECC) is a multifactorial, biofilm-mediated, sugar-related, dynamic disease of primary dental hard tissues occurring in varying degrees of severity in infants and toddlers. Untreated ECC may lead to pain, infections, and severe systemic complications. The aim of this study was to systematically review and evaluate the scientific evidence on the cost-effectiveness of treatment decisions in ECC in infants and toddlers. Materials and Methods: Observational epidemiological studies, i.e., cohort studies, case–control studies, and randomized controlled trials, reporting cost-effectiveness of treatment decisions in ECC in infants and toddlers were included in the systematic review following the PRISMA guidelines. Using an ad hoc search with search terms or keywords (MeSH), electronic databases Embase, MEDLINE via PubMed, Scopus, and gray literature were searched. Results: The search identified 494 articles, of which 446 remained after removing duplicates. A total of 417 articles were excluded after title and abstract evaluation; 29 full-text articles were screened for eligibility, and five articles were discarded. Twenty-four full-text articles were included in the systematic review, assigning 17 to prevention and seven to restoration. Results were heterogeneous; comparability of included studies is difficult because of the different methodologies used. Conflicting efficacies were demonstrated for different interventions implemented, and cost-effectiveness data were documented. Conclusions: Socioeconomic, cultural, and ethnic differences must be considered when comparing conditions in terms of cost-effectiveness. A paradigm shift from surgical towards preventive treatment decisions can be observed. Cost-effectiveness studies on therapies for ECC in infants and toddlers are needed to identify the best practice approach and the most cost-effective therapy decisions.

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An economic evaluation of pit and fissure sealants and fluoride varnishes in preventing dental caries: a systematic review

2023

Journal of Clinical Pediatric Dentistry

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The aim was to systematically evaluate the cost-effectiveness of pit and fissure sealants (PFSs) compared with that of fluoride varnishes (FVs) in dental caries prevention. We searched four electronic databases including the Cochrane Oral Health Group’s Trials Register (till 03 June 2022), Web of Science (from 1945 to 03 June 2022), PubMed (from 1996 to 03 June 2022), and EMBASE via Ovid (from 1980 to 03 June 2022) to identify the cost and effectiveness of PFSs and FVs in decreasing dental caries incidence. Two researchers independently screened search results, extracted data from the included studies, and conducted the risk of bias assessments. The main characteristics of the included studies were extracted and analyzed. The initial search produced 874 articles. After removing duplicates and full-text review, 19 studies were included. In this study: nine studies were on PFSs comparison with control; five on PFSs comparison with FVs; and five on FVs comparison with control. Regarding the type of economic evaluation (EE), 13 studies conducted cost-effectiveness analysis, five conducted cost-utility analyses, and one conducted both cost-effectiveness analysis and cost-utility analyses. The cost-effectiveness evaluation of PFSs and FVs in the available studies was limited. The prevalence of dental caries, payers’ willingness to pay, length of follow-ups, delivery settings, retention rate of PFS, and application intervals of FV can affect the economic evaluation of these two methods for dental caries prevention. Therefore, more studies in the future are need to draw clear conclusions about which method is more cost-effective for the two preventive interventions in future.

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Pit-and-fissure sealants on primary molars are a cost savings

Cited by 3 publications

References 11 publications

Cost-Effectiveness of Pit and Fissure Sealing at Schools for Caries Prevention in China: A Markov Modeling Analysis

Cost-Effectiveness of Pit and Fissure Sealing at Schools for Caries Prevention in China: A Markov Modeling Analysis

Cost-Effectiveness of Treatment Decisions for Early Childhood Caries in Infants and Toddlers: A Systematic Review

An economic evaluation of pit and fissure sealants and fluoride varnishes in preventing dental caries: a systematic review

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