Assessing cost-effectiveness of sealant placement in children

Rocio B. Quiñonez, Stephen Downs, Dan Shugars, John Christensen, William F. Vann

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: The lack of cost-effectiveness information regarding sealant placement strategies is thought to have influenced reimbursement policies and subsequent sealant utilization in dental practice. This study compared three strategies for managing the occlusal surfaces of first permanent molars: seal all (SA), risk-based (RBS), and seal none (SN). Methods: A decision tree was developed for various possible outcomes following each of the above strategies. Due to the complexity of the decision tree, a Markov model was used to allow for the construction of a chain of events representing the natural history of sealant retention, caries formation, and their associated health states. The outcome measures were the incremental cost per month gained in a cavity-free state over a ten-year period. Results: Our theoretical model showed that RBS strategy improved clinical outcomes, in the form of cavity-free months, and saved money over SN. The strategy of sealing both high and low risk teeth (SA) further improved outcomes but at an additional cost compared to RBS. However, the cost was small, $.08 for each additional cavity-free month gained per tooth. Further, minor changes in the baseline assumptions resulted in the SA strategy being the dominant strategy. Conclusion: This study provides evidence that sealing children's first permanent molars can improve outcomes and save money by delaying or avoiding invasive treatment and the destructive cycle of caries. In a time of limited funds for dental services, these results can assist payers in establishing more rational sealant reimbursement policies.

Original languageEnglish
Pages (from-to)82-89
Number of pages8
JournalJournal of Public Health Dentistry
Volume65
Issue number2
StatePublished - Mar 2005

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Cost-Benefit Analysis
Tooth
Decision Trees
Costs and Cost Analysis
Financial Management
Natural History
Theoretical Models
Outcome Assessment (Health Care)
Health
Therapeutics

Keywords

  • Cost-effectiveness
  • Decision analysis
  • Markov model
  • Sealant

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Quiñonez, R. B., Downs, S., Shugars, D., Christensen, J., & Vann, W. F. (2005). Assessing cost-effectiveness of sealant placement in children. Journal of Public Health Dentistry, 65(2), 82-89.

Assessing cost-effectiveness of sealant placement in children. / Quiñonez, Rocio B.; Downs, Stephen; Shugars, Dan; Christensen, John; Vann, William F.

In: Journal of Public Health Dentistry, Vol. 65, No. 2, 03.2005, p. 82-89.

Research output: Contribution to journalArticle

Quiñonez, RB, Downs, S, Shugars, D, Christensen, J & Vann, WF 2005, 'Assessing cost-effectiveness of sealant placement in children', Journal of Public Health Dentistry, vol. 65, no. 2, pp. 82-89.
Quiñonez RB, Downs S, Shugars D, Christensen J, Vann WF. Assessing cost-effectiveness of sealant placement in children. Journal of Public Health Dentistry. 2005 Mar;65(2):82-89.
Quiñonez, Rocio B. ; Downs, Stephen ; Shugars, Dan ; Christensen, John ; Vann, William F. / Assessing cost-effectiveness of sealant placement in children. In: Journal of Public Health Dentistry. 2005 ; Vol. 65, No. 2. pp. 82-89.
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