Journal of dentistry · 2026
Fluoride varnish for preventing dental caries among children: a systematic review and meta-analysis of cost-effectiveness studies.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Kumar Ram Surath, Gupta Arpit, Sharda Shweta, Bagepally Bhavani Shankara, Monga Nitika, Goyal Ashima
Аннотация
OBJECTIVES: This study aims to synthesize the incremental net monetary benefit (INMB) of fluoride varnish (FV) application in comparison with other caries preventive interventions in children.
DATA: Of 836 studies identified, a total of 23 studies were included. The majority of FV intervention studies conducted in comparison with oral health education (OHE) (n= 5), treatment as usual (TAU) (n= 3), and pit and fissure sealant intervention (n= 5), toothbrushing intervention (n= 5), and no intervention (n= 7). Only model-based studies on FV conducted in high-income countries (HICs), from a healthcare provider/payer perspective, comparing with other caries preventive interventions (OHE, TAU, or no intervention), irrespective of the setting, were eligible for pooling. A total INMB was calculated. The overall meta-analysis of FV compared with other caries preventive interventions revealed that the total INMB was $124.1 (95%CI: -$1.3 × 104, $1.3 × 104, I²=0%), showing no significant difference in the cost-effectiveness between FV and other caries preventive interventions.
SOURCES: A literature search was performed using electronic databases (PubMed, Web of Science, Scopus, and the Cochrane Library) for studies published from inception to January 2024. Risk of bias was assessed using a modified Economic Evaluations Bias checklist.
STUDY SELECTION: Two independent reviewers identified cost-effectiveness studies reporting dental health and/or generic health outcomes of FV application. Sub-group meta-analyses by type of comparators, study design, perspective, country income level, effect measure, and type of setting used were performed to pool INMB across studies.
CONCLUSIONS: Considering the limited evidence, the cost-effectiveness of FV application is uncertain in HICs from healthcare provider/payer perspective.
CLINICAL SIGNIFICANCE: Overall, the evidence highlights the potential economic value of fluoride varnish in caries prevention, especially in settings lacking robust cost-effectiveness data. The findings can guide policy decisions in resource-constrained environments where generating local evidence is challenging.
PROTOCOL REGISTRATION: Registered at PROSPERO (CRD42023483985).
SOURCE OF FUNDING: The authors declare that there was no funding for this study.
DATA: Of 836 studies identified, a total of 23 studies were included. The majority of FV intervention studies conducted in comparison with oral health education (OHE) (n= 5), treatment as usual (TAU) (n= 3), and pit and fissure sealant intervention (n= 5), toothbrushing intervention (n= 5), and no intervention (n= 7). Only model-based studies on FV conducted in high-income countries (HICs), from a healthcare provider/payer perspective, comparing with other caries preventive interventions (OHE, TAU, or no intervention), irrespective of the setting, were eligible for pooling. A total INMB was calculated. The overall meta-analysis of FV compared with other caries preventive interventions revealed that the total INMB was $124.1 (95%CI: -$1.3 × 104, $1.3 × 104, I²=0%), showing no significant difference in the cost-effectiveness between FV and other caries preventive interventions.
SOURCES: A literature search was performed using electronic databases (PubMed, Web of Science, Scopus, and the Cochrane Library) for studies published from inception to January 2024. Risk of bias was assessed using a modified Economic Evaluations Bias checklist.
STUDY SELECTION: Two independent reviewers identified cost-effectiveness studies reporting dental health and/or generic health outcomes of FV application. Sub-group meta-analyses by type of comparators, study design, perspective, country income level, effect measure, and type of setting used were performed to pool INMB across studies.
CONCLUSIONS: Considering the limited evidence, the cost-effectiveness of FV application is uncertain in HICs from healthcare provider/payer perspective.
CLINICAL SIGNIFICANCE: Overall, the evidence highlights the potential economic value of fluoride varnish in caries prevention, especially in settings lacking robust cost-effectiveness data. The findings can guide policy decisions in resource-constrained environments where generating local evidence is challenging.
PROTOCOL REGISTRATION: Registered at PROSPERO (CRD42023483985).
SOURCE OF FUNDING: The authors declare that there was no funding for this study.