Clinical and economic analysis of dental caries prevention using fluorine-containing sealants

Aim. To conduct a clinical and economic analysis of the effectiveness of the program fissure sealing of first permanent molars with fluorine-containing sealants among schoolchildren of 7–8 years old in six cities of the Republic of Tatarstan.

Methods. Between 2007 and 2011, dentists of six cities of the Republic of Tatarstan performed fissure sealing of permanent first molars using a fluorine-containing sealant in 24,394 schoolchildren aged 7–8 years according to the manufacturer's instruction. A clinical assessment of fluorine-containing sealant retention during tooth eruption was carried out annually, the results were submitted to the organizational and methodological office of the Republican Dental Clinic. The analysis of the complex of signs that have a normal distribution and characterize four degrees of sealant retention on the occlusal surfaces of teeth in children from several cities was carried out by using one-way ANOVA (analysis of variance) with the calculation of a p-value and F-test (according to Ronald Fischer). Statistical data processing was performed using the Microsoft Office Excel 2017 software. The economic analysis was performed by using mathematical modelling.

Results. The use of sealants at the age of 7–8 years ensured the complete safety of the sealant in 80% of children; the development of dental caries in 1.7%; complete and partial loss — 14.3%; disturbance of fit without the development of caries — in 4.1% of cases [р=0.0095 (<0.01); f-test 3.09839]. Clinical and economic analysis using a mathematical hypothesis in sealing with a fluorine-containing composite sealant determined the preservation of the conditionally spent funds for the treatment of 80% of healthy teeth for 4 years of the project in the amount of 6,001,177 rubles. Notional saved costs for the treatment of one tooth with a sealant amounted to 23.7 rubles.

Conclusion. Implementation of the program fissure sealing of first permanent molars with fluorine-containing sealants among schoolchildren of 7–8 years old allows a total of 98.3% of healthy teeth to be preserved and notionally saved costs of sealing fissures to be reduced.