Caries Res 2017;51:489-499
Abstract
We conducted a 3-year cost-effectiveness analysis on the
cavitated dentine carious lesion preventive capabilities of composite
resin (CR) (reference group) and atraumatic restorative treatment (ART)
high-viscosity glass-ionomer cement (HVGIC) sealants compared to
supervised toothbrushing (STB) in high-risk first permanent molars.
School children aged 6-7 years in 6 schools (2 per group) received CR
and ART/HVGIC sealants or STB daily for 180 days each school year. Data
were collected prospectively and cost estimates were made for sample
data and a projection of 1,000 sealants/STB high-risk permanent molars.
Although STB had the best outcome, its high implementation cost (95% of
cost for supervisors visiting schools 180 days/school year) affected the
results. ART/HVGIC was cost-effective compared to CR for the sample
data (savings of USD 37 per cavitated dentine carious lesion prevented),
while CR was cost-effective compared to ART/HVGIC for the projection
(savings of USD 17 per cavitated dentine carious lesion prevented), and
both were cost-saving compared to STB. Two STB scenarios were tested in
sensitivity analyses with variations in caries incidence and number of
supervision days; results showed STB had lower costs and higher savings
per cavitated dentine carious lesion prevented than CR and ART/HVGIC. A
major assumption is that both scenarios have the same high effectiveness
rate experienced by STB under study conditions; however, they point to
the value of further research on the benefits of adopting STB as a
long-term venture in a general population of school children.
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