Topical applications of fluoride varnish have demonstrated the strongest evidence for clinical effectiveness in preventing early childhood caries.
This study shows that fluoride varnish is also more cost effective than usual dental care.
Fluoride varnish programs should continue to focus on children in disadvantaged areas and potentially expand to include all school-aged children.
Objective: This project compares the cost effectiveness of a preventive fluoride varnish (FV) program with usual dental care (surgery under general anesthesia [GA]) for preschool children in 2 low-income communities in Winnipeg, Canada.
Methods: Program impact is described in terms of cost, cavities avoided, and reductions in surgery volume. Aggregate data for 873 children ages 1 to 6 years old enrolled in the Winnipeg Regional Health Authority Daycare Fluoride Varnish Program in January 2018 were analysed using a Markov model.
Results: The program was found to save approximately $822.98 per child over 5 years versus usual dental care. There were 4.38 cavities avoided per child and a savings of $187.71/cavity for the FV group. Participants’ need for dental surgery under GA was reduced from 19.1% in the usual care group to 1.6% in the FV group (92% reduction) over 5 years. Sensitivity analyses using a Monte Carlo simulation showed that the program was cost effective over usual care 100% of the time. Finally, it was estimated that the program had saved $753,000 since its inception, or approximately $41.15 per FV application.
Conclusion: The FV intervention had better health outcomes, lower costs, and was less invasive than usual care involving dental surgery under GA for children enrolled in the program.
Keywords: Markov model; cost effectiveness; early childhood caries; fluoride varnish; low income area; prevention.
*Full study online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668277/