Cost minimisation analysis of two occlusal caries preventive programmes

Fissure sealants have been recommended for the prevention of pit and fissure caries since the 1970s. Few comparative studies have examined the cost-effectiveness of these procedures. This study reports on the cost minimisation analysis conducted as part of a field trial which compared the caries preventive effects of a programme comprising selective fissure sealing and application of topical fluorides on first permanent molars (control) with a programme of professional cleaning and oral health education (test).

The carious outcomes from the field trial were used to assign probability values to a hypothetical cohort of 100 children provided with the test or the control treatment. Incremental cost-effectiveness ratios were calculated using a 5% discount rate. Sensitivity analyses were conducted to test the sensitivity of the findings to the discount rate and labour costs.

An incremental cost-effectiveness ratio of a $40/child/year after two years for the test programme was found.

The findings suggest that the test programme comprising professional cleaning and oral health education should not be adopted on economic grounds. A longer period, of observation may be necessary before definitive conclusions regarding the cost-effectiveness of the preventive programmes can be made.