Oral Health Impact and Cost-Effectiveness of Resealing First Permanent Molars

This study examined the cost-effectiveness and health impact of various dental sealant resealing scenarios for first permanent molars from the payer perspective.

The authors used a discrete event simulation model for 4,000 recently sealed first molars in a hypothetical cohort of 1,000 children aged 7 years over a 10-year time horizon. Scenarios included a base case of no resealing, resealing at first dental visit, and resealing at the age of 12 years.

Without resealing, only 34.88% of teeth retained sealants after 10 years, whereas resealing at the age of 12 years increased this to 53.05%, and resealing at first dental visit increased it to 43.48%. Resealing at age 12 years significantly reduced decay experience to 26.65%, and resealing at first dental visit reduced it to 25.30%, compared with 41.15% for no resealing. The number of accrued disability-adjusted life years was highest for no resealing (5.35). This number reduced to 3.52 for resealing at age of 12 years and 3.19 for resealing at the first dental visit. Cost-effectiveness analysis showed that the most effective resealing scenario, resealing at the first dental visit, also had the lowest cost per averted cavity ($43.03) and cost per averted disability-adjusted life year ($6,753).

This simulation model indicates that resealing significantly reduces dental decay over 10 years at reasonable costs, using conservative modeling assumptions. These findings suggest that insurance companies and Medicaid could benefit from implementing resealing policies to improve dental health outcomes by reducing caries and filling costs.