Send to

Choose Destination
Community Dent Oral Epidemiol. 2018 Feb;46(1):38-46. doi: 10.1111/cdoe.12326. Epub 2017 Sep 6.

Economic evaluation of dental sealants: A systematic literature review.

Author information

Department of Health Policy & Management, Texas A&M University School of Public Health, College Station, TX, USA.
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawaiì at Mānoa, Honolulu, HI, USA.
Harvard School of Public Health, François-Xavier Bagnoud Center For Health and Human Rights, Boston, MA, USA.



To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants.


Of 21 full-text articles examined, a total of 13 were included in this study. These studies are grouped by the type of intervention as follows: (i) sealants compared with no sealants; (ii) sealants compared with other forms of caries prevention; (iii) resin-based sealants compared with glass-ionomer sealants; (iv) different sealing strategies in primary teeth; (v) different sealing strategies in permanent teeth; and (vi) sealants based on school- or clinic-based setting of delivery. All currency is reported in constant 2010 US$.


Cost-effectiveness analyses differed due to varying study designs, assumptions, sealant delivery settings, outcomes, caries risk assessment and study durations. Findings varied on the cost-effectiveness of sealants compared with other caries-preventive strategies. Under the assumption of equal caries risk, always sealing primary molars appeared to be the most effective strategy, whereas risk-based sealing was the optimal strategy with differing caries risk. Studies that assessed sealing strategies in permanent teeth reported that risk-based sealing was more cost-effective than not sealing, but they differed on the cost-effectiveness of risk-based seal compared with non-risk-based seal. Sealants delivered in school settings had mixed results on costs but were as equally effective as sealants delivered in private practices.


The cost-effectiveness of sealants is dependent on the conditions of delivery. The list of cost-effectiveness ratios for each intervention can support policy makers to estimate expected returns on their investments in dental sealants.


cost analysis; cost-benefit analysis; cost-effectiveness analysis; economic evaluation; pit and fissure sealants

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center