A RETROSPECTIVE ANALYSIS OF THE COST-EFFECTIVENESS OF DENTAL SEALANTSIN A CHILDRENS HEALTH-CENTER

A retrospective patient record analysis was conducted to study the cos t-effectiveness of dental sealants placed under routine, unrestricted practice condition in a fluoridated community. The 26 dentists who pro vided care at the clinic over the period of the study used their own c linical judgement to determine sealant placement or alternative treatm ent. Dental services for 275 patients at a children's dental clinic fo r low-income families were evaluated. All children had at least 3 year s between their first and last dental visit (mean = 5.8 years). A life table analysis was conducted to compare the probability of survival (r estoration-free tooth years) and costs incurred to first molars of chi ldren who did not receive sealants, received any sealants, or received sealants on all first molars. Among the children with sealants, compa risons were also made between sealed and unsealed teeth in children wh o did and did not have a first molar restoration prior to sealant plac ement. Costs included the cost of sealants and restorative treatments for these teeth over time. Depending on the conditions under which sea lants were placed, cost-savings or improving cost-effectiveness with t ime were found. A strategy of identifying children with prior restorat ions and sealing the remaining molars showed cost-savings within 4-6 y ears. For other comparisons, incremental cost-effectiveness ratios bec ame more favorable over time.