Treatment outcomes and costs of dental sealants among children enrolled inMedicaid

Objectives. This retrospective cohort analysis of children enrolled in the North Carolina Medicaid program compared the likelihood of restorative trea tments and associated cumulative Medicaid expenditures for teeth with or wi thout dental sealants. Methods. We assessed the dental experience of the cohort of 15438 children from 1985 to 1992 on the basis of enrollment and claims files. We conducted regression analyses for outcomes (caries-related services involving the oc clusal surface [CRSOs] of permanent first molars) and cumulative expenditur es, controlling for characteristics of the child, the treating dentist, and the child's county of residence. Results. Overall, 23% of children received at least 1 sealant and 33% at le ast 1 CRSO. Sealants were effective in preventing CRSOs, although the degre e of effectiveness was highest for children with the greater levels of CRSO s before sealant placement. Estimated cumulative Medicaid expenditures indi cated expenditure savings from sealants within 2 years of application for c hildren with 2 or more prior CRSOs. Conclusions. Sealant placement was associated with expenditure savings to M edicaid for certain highrisk children, so Medicaid and, more broadly, socie ty will benefit by providing for sealant placement in these children.