Real-world effectiveness of national pit and fissure sealants program in Taiwan

Po-Yen Lin; Le-Yin Hsu; Hsuan-Lu Alicia Ko; Perng-Haur Wang; Ping-Yi Lin; Lin-Yang Chi

doi:10.1016/j.jdent.2023.104587

Real-world effectiveness of national pit and fissure sealants program in Taiwan

J Dent. 2023 Aug:135:104587. doi: 10.1016/j.jdent.2023.104587. Epub 2023 Jun 13.

Authors

Po-Yen Lin¹, Le-Yin Hsu², Hsuan-Lu Alicia Ko³, Perng-Haur Wang⁴, Ping-Yi Lin⁵, Lin-Yang Chi⁶

Affiliations

¹ Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Graduate Program of Data Science, National Taiwan University and Academia Sinica, Taipei, Taiwan.
³ Andersen 4 Kid Dental Clinic, Hsinchu City, Taiwan.
⁴ Department of Oral Health, Ministry of Health and Welfare, Taipei, Taiwan.
⁵ Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁶ Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. Electronic address: chily@nycu.edu.tw.

PMID: 37321335
DOI: 10.1016/j.jdent.2023.104587

Abstract

Objectives: This study investigated the effectiveness of a national population-based pit and fissure sealants (PFS) program in Taiwan.

Methods: Part 1 (effectiveness of national PFS program) involved children who had participated in the PFS program from 2015 to 2019. After propensity score matching, 670,840 children were selected for analysis until the end of 2019. During follow-up, the permanent first molars of the participants were assessed for caries-related treatments by employing multilevel Cox proportional hazards models. In Part 2 (effectiveness of retained sealants), which involved 1,561 children, sealant retention was evaluated 3 years after placement. A structured questionnaire was employed to collect information on family and individual factors. The endpoints were the same as in Part 1.

Results: In Part 1, the adjusted hazard ratios (HRs) for caries-related treatments among participants in the PFS program were 0.90 (95% confidence interval [CI] = 0.89, 0.91) for dental restoration, 0.42 (95% CI = 0.38, 0.46) for initiation of endodontic treatment, 0.46 (95% CI = 0.41, 0.52) for completion of endodontic treatment, and 0.25 (95% CI = 0.18, 0.34, all Ps < 0.0001) for extraction. In Part 2, the adjusted HR for dental restoration of teeth with retained sealants was 0.70 (95% CI = 0.58, 0.85), significantly lower than that for teeth without retained sealants (P = 0.0002).

Conclusions: Participation in the national PFS program was associated with a significant reduction of at least 10% in the risk of caries-related treatments, and an additional 30% risk reduction may have been attributed to sealant retention.

Clinical significance: In a real-world setting, schoolchildren in the national PFS program were associated with a significant reduction of at least 10% in the likelihood of caries-related treatments. The program provided moderate protection against caries for the study population and could be improved by increasing the sealant retention rate.

Keywords: Pit and fissure sealants; Primary prevention; Schoolchildren; Taiwan national health insurance research database.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Dental Caries* / prevention & control
Humans
Molar
Pit and Fissure Sealants* / therapeutic use
Proportional Hazards Models
Taiwan

Substances

Pit and Fissure Sealants