Economic evaluation of school-based caries preventive programs: A systematic review.

OBJECTIVE: Assess interventions and health outcomes in studies giving data on economic evaluation (EE) of school-based caries prevention. BASIC RESEARCH DESIGN: Systematic review. Both partial EE that included cost description, cost-outcome description, cost analysis and full EE that included both cost and outcome of at least 2 interventions were included. Quality assessment used the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. RESULTS: An electronic search of 6 databases identified 558 titles and abstracts. Paper eligibility screening identified 32 full papers which met the inclusion criteria. Most were conducted in the United States and cost effectiveness analysis was the most common type of EE. Nine were model-based studies and 17 derived their data from single studies. Sealants were most frequently evaluated followed by fluoride mouthrinse. Many CHEERS criteria were not met in the included studies. The following were found to be cost-effective: school-based, under general supervision, longer duration of program and targeting high caries risk groups. CONCLUSIONS: The deficiencies in the existing studies warrant more investigations of the economic aspects of school-based activities interventions to prevent caries.