| Objective:1.To evaluate the 3 years’clinical effect of pit and fissure sealant in children who have participated in the Oral health promotion program in Nanning, Guangxi, China.2. To analyze the economic benefits of the program, and provide scientific evidence for the government to make policy for oral health.Methods:There were 14 medical institutions and 92 primary schools that participated in the Oral health promotion program in Nanning, Guangxi, China in 2011. The study was carried from April to June,2014.10 medical institutions and 24 primary schools who match the medical institution were selected to study according the medical institution’s technical level. One or two classes in grade 5 were randomly selected from each school. Children from the classes which were selected were divided into two groups:The experimental group and control group. Children who were given pit and fissure sealing in 2011 were in the experimental group. All others were in control group. The status of caries and pit and fissure sealing in the first permanent molars were examined. The average cost for treatments on caries, root canal, prostheses was conducted in Nanning for evaluation of the economic benefits of the program. The data were analyzed by SPSS19.0 statistical software.Results:1. Descriptive results1.1 Demographic and social characteristics of the sampleIn this study,10 medical institutions and 24 primary schools were included, the children aged 10 to 13 years old. In the experimental group,826 subjects were examined which consisted 452 boys and 374 girls, and a total of 2862 first permanent molars had been accepted pit and fissure sealant; in the control group, 654 people were examined that included 357 boys and 297 girls, and a total of 2616 first molars had not been accepted sealant.1.2 Clinical status of the pit and fissure sealant2473 occlusal and buccal/palatal surfaces of the first permanent molars’ had been sealed in the experimental group. The 3-year complete retention rate, partial retention rate, and the missing rate of sealant were 8.73%,58.87%, 32.39%. The missing rate of sealant on the buccal/palatal surface was 72.99%, higher than that on the occlusal surface(32.18%), and the partial retention rate on the occlusal surface (53.42%) was higher than that on the buccal/palatal surface (14.40%). The difference was significantly (P<0.01). The difference between the sealant retention rate in maxillary first permanent molarsand and mandibular first permanent molars showed no significant differences (P> 0.05).2.The caries-preventive effect of pit and fissure sealantIn the experimental group, the caries prevalence was 53.6%, the mean DMFT was (1.12 ± 0.89). However, the caries prevalence was 73.2% and mean DMFT was (2.03 ± 1.05) in control group. The difference between two group was significantly (P<0.01). In the experimental group, the new caries rate of first permanent molars was 22.78%, it means there still was 22.78% teeth which had accepted pit and fissure sealant 3 years ago suffered from caries until now. Compared the experimental group to the control group, the relative depress rate of caries was 50.79%, the actual depress rate of caries was 23.52%.3. The relationship between sealant retention rate and dental cariesThe sealant retention rate was associated with the caries prevalence (P <0.01). The higher the retention rate of sealant, the better the preventive effect on dental caries.4. The economic benefits of the pit and fissure sealantAbout 13,000 first permanent molars had been given pit and fissure in this program. According to the actual depress rate of caries (23.52%), we can roughly estimate that about 3057 first permanent molars may be avoided caries due to pit and fissure sealant. Pit and fissure sealant cost approximately 18 yuan per teeth. If teeth suffered from shallow caries, filling with glass ionomer which cost 100 yuan, and 180 yuan for resin material. If teeth was developed to pulpitis, which need to insert a metal core into the tooth and make a crown after root canal therapy, it will cost 1,140 yuan, and total of treatment reach 3,484,980 yuan. If these teeth were given pit and fissure sealant, most of the children and their parents would save time, money and social resources as well. At the same time it will make great contributions to the healthy growth of children.Conclusions:1. The 3 years’fully retention rate was8.73%, partly retention rate was 58.87%, and the sealant retention rate associated with the caries prevalence, the higher the retention rate, the better the preventive effect. The sealant retention rate on occlusal surface was higher than that on the buccal/palatal surface. The actual depress rate of caries in the experimental group was 23.52%. Pit and fissure sealing is an effective way for preventing dental caries.2. The program was targeted at pit and fissure sealant, it was cost-effective, and improved medical efficiency,reduced government and individual medicals expenditures, and was worthy of being generalized. |
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