Cost minimisation analysis of two occlusal caries preventive programmes

Objective: Fissure sealants have been recommended for the prevention of pit and fissure caries since the 1970s. Few comparative studies have examined the cost-effectiveness of these procedures. This study reports on the cost minimisation analysis conducted as part of a field trial which compared the caries preventive effects of a programme comprising selective fissure sealing and application of topical fluorides on first permanent molars (control) with a programme of professional cleaning and oral health education (test). Design: The carious outcomes from the field trial were used to assign probability values to a hypothetical cohort of 100 children provided with the test or the control treatment. Incremental cost-effectiveness ratios were calculated using a 5% discount rate. Sensitivity analyses were conducted to test the sensitivity of the findings to the discount rate and labour costs. Results: An incremental cost-effectiveness ratio of A$40/child/year after two years for the test programme was found. Conclusion: The findings suggest that the test programme comprising professional cleaning and oral health education should not be adopted on economic grounds. A longer period, of observation may be necessary before definitive conclusions regarding the cost-effectiveness of the preventive programmes can be made.