Economic evaluation of a pit and fissure dental sealant and fluoride mouthrinsing program in two nonfluoridated regions of Victoria, Australia.

OBJECTIVES This study assessed the cost effectiveness of a three-year school-based pit and fissure dental sealant and fluoride mouthrinsing program in two nonfluoridated regions in Victoria, Australia. METHODS The analysis was based on a community intervention in five schools comparing an intervention group receiving the pit and fissure dental sealant, a weekly fluoride mouthrinsing, and an annual oral hygiene education session, with a control group receiving oral hygiene education only. The study measured mean differences in DMFS increments between study groups. RESULTS The mean discounted DMFS difference in increment (DMFS avoided) between study groups was 1.22 DMFS over three years. The incremental cost-effectiveness ratio comparing intervention to control group varied between a net savings of $7.00 to a cost of $35.60 per DMFS avoided, depending on assumptions used in the analysis. Results were sensitive to assumptions on program effectiveness, dental examination rates, and baseline DMFS of students. The program became more cost effective with each successive year of the program. CONCLUSIONS The introduction of such a preventive program in nonfluoridated regions of Victoria will represent an efficient use of community resources. Policy issues that need consideration include whether to target areas where adolescents have a history of high dental disease experience, and whether dentists or auxiliaries are used as service providers. The need exists for a systematic evaluation (including an economic evaluation component) of dental prevention and treatment programs in Australia.