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Calculating averted caries attributable to school-based sealant programs with a minimal data set.

Susan O Griffin1, Kari Jones, Matthew Crespin

  • 1Division of Oral Health, Centers for Disease Control, Atlanta, GA, USA.

Journal of Public Health Dentistry
|January 16, 2014
PubMed
Summary

This study presents a method for school-based sealant programs (SBSP) to estimate averted cavities using minimal data. The approach accurately quantifies the impact of sealant interventions on preventing tooth decay.

Keywords:
Markov chainspit and fissure sealantsprogram evaluation

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Area of Science:

  • Dental Public Health
  • Preventive Dentistry
  • Health Services Research

Background:

  • School-based sealant programs (SBSP) are crucial for preventing dental caries in children.
  • Accurate estimation of the impact of SBSP, specifically averted cavities, is essential for program evaluation and resource allocation.
  • Existing methods may require extensive data, posing a challenge for resource-limited programs.

Purpose of the Study:

  • To develop and validate a methodology for SBSP to estimate averted cavities over a 9-year period using a minimal dataset.
  • To assess the sensitivity of the estimated averted cavities to potential inaccuracies in program data, such as annual attack rate and retention rates.

Main Methods:

  • A Markov model was employed to estimate averted cavities.
  • The model utilized inputs for annual attack rate (AR) and 1-year sealant retention rate.
  • Child-level data on sealant presence, decayed/filled first molars, and age were used to estimate AR, with a literature-derived functional form for long-term retention.

Main Results:

  • Demonstration with Wisconsin SBSP data (7% AR, 92% 1-year retention) showed 31,324 sealants averted 10,718 cavities.
  • Sensitivity analysis revealed that errors in estimating averted cavities were less than errors in AR and equal to errors in 1-year retention.
  • Estimates of averted cavities were more reliable for higher-risk children regarding AR misspecification.

Conclusions:

  • A user-friendly methodology, supported by Excel spreadsheets, enables SBSP to generate reliable estimates of their cavity prevention impact.
  • This approach facilitates evidence-based program assessment and improvement with minimal data requirements.
  • The methodology provides a practical tool for demonstrating the value of school-based sealant interventions.