Fissure sealants: a critique of their cost-effectiveness

Despite the large number of clinical trials demonstrating the effectiveness of fissure sealants in preventing occlusal caries, it has been suggested that the fundamental principles of cost-effectiveness have not been applied to the use of fissure sealants and there is little in the literature which allows up-to-date judgements to be made. A review of the literature suggests that whilst the limitations in design of some of the earlier fissure sealants studies make it difficult to draw firm conclusions, the results of later studies, particularly those which evaluated fissure sealants as an integral part of routine dental care, are encouraging. A number of factors including durability and tooth selection influence the economic viability of fissure sealants. These factors must be considered and controlled if sealants are to be used cost-effectively.