[Fissure sealants versus fluorine varnish on the first permanent molars: economic assessment]

Abstract

Objective: To study school-children between the ages of 6 and 8 in order to make an economic comparison between two programmes aimed at preventing caries in the first permanent molars: sealants or fluorine varnish.

Design: A field trial over 24 months, with three groups of school-children (sealant/varnish/control).

Setting: Primary Care in the school environment (Granada).

Patients: 362 school-children between 6 and 8: 314 were followed for 24 months (100 sealant, 98 varnish and 116 control group).

Intervention: Sealant and fluorine varnish on the first healthy permanent molars, with weekly reapplications, using portable equipment.

Measurements and main results: The increase was measured over a 24-month period in both the DMFT (the total of the first permanent molars either with caries, missing because of caries or sedice filled) and the DMFS (DMFT, but referring to the surface) indexes. In relation to the DMFT, the effectiveness of the sealant (difference in increase of DMFT between the sealed and control groups) was -1.06 (Standard Error = 0.16) and of the varnish, -0.58 (SE = 0.18), which were statistically different figures. For DMFS, the effectiveness of the sealant was -1.83 (SE = 0.28) and of the varnish, 1.10 (SE = 0.33), also different. The costs per school-child did not differ sealant: 4,524 pesetas (SD = 1,248), and varnish: 4,373 (SD = 1,267). The cost/effectiveness ratio favored the sealant (4,268 pesetas per molar saved against 7,540).

Conclusions: The sealant is more efficient (twice that of the varnish). The cost of saving a molar is 4,268 pesetas.