Pit and fissure sealant program in Lithuania Sigulda

Pit and fissure sealant program in Lithuania Sigulda 2011

Decrease in dental caries � The effect of fluoride? � The effect of sealants? The Cochrane Review estimated that the caries-preventive effect ranges from 87% at 12 months to 60% at 48– 54 months, but heavily depends on sufficient retention of the sealant. Ahovuo-Saloranta et al. , 2008

Sealants for erupting teeth Tooth brushing with fluoridated toothpaste is the first choice to control caries development. Tooth brushing twice a day with a 1, 450– 1, 500 ppm fluoridated toothpaste by trained parents and/or children, supplemented with 2– 4 topical fluoride applications annually are advisable in order to control occlusal caries development during the eruption period Marinho VC, Higgins JP, Logan S, Sheiham A: Fluoride gels for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2002; 2: CD 002280. Marinho VC, Higgins JP, Sheiham A, Logan S: Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003; 1: CD 002278.

Pit and fissure sealant program in Lithuania total population of 6 -13 years old 325, 448 number of patients with sealed teeth 310, 944 282, 605 270, 285 249, 856 43, 556 2004 39, 515 2005 50, 092 2006 41, 747 2007 45, 65 2008 244, 548 39, 239 2009

Children’s pit and fissures sealants program financing in Lithuania 3, 03 2 2, 1 2 2, 01 1, 9 1, 6 1, 7 1, 5 1, 6 2, 01 1, 5 0, 9 2005 2006 2007 2008 allocated (mln. Lt) 2009 used (mln. Lt) 2010 2011

Number of services provided during pit and fissure sealant program in 2006 – 2010 number of sealed teeth 64 577 61 209 59 077 51 305 2 006 2 007 2 006 2 008 2007 2008 2 009 2010 49 063 2 010

Number of services provided during pit and fissure sealant program (by number of teeth sealed) in 2007 – 2010 29016 23790 24175 21857 16086 1518714668 14252 12027 9220 9021 7174 7786 7202 6541 4 teeth 3 teeth 2007 2 teeth 2008 2009 2010 1 tooth 10282

Enrolment in pit and fissure sealant program in Lithuania in 2004 -2009 Year 2004 2005 2006 2007 2008 2009 Participants in pit and fissure sealant program as share of total 6 -13 population (%) 11. 8 11. 28 15. 6 13. 38 15. 45 13. 83

Sealed teeth in different age groups The number of sealed teeth (%) 4 and > 3 the number of sealed teeth 2 1 0 9, 2 9, 6 13, 5 11, 6 9, 5 7, 4 7, 5 22, 5 12 years old 15, 9 9 years old 7 years old 15, 1 16, 5 11, 5 35, 4 56, 7 58, 1 K. Saldūnaitė, A. Pūrienė, S. Milčiuvienė, V. Brukienė, J. Kutkauskienė. Analysis of dental caries prevention program in 7– 12 -year-old Lithuanian schoolchildren Medicina (Kaunas) 2009; 45(11)

The effectiveness of the sealant program The prevalence of dental caries 7 -8 years old 12 years old 1999 -2001 33. 7 74. 6 2007 20. 4 66. 9 • 164. 000 participated in pit and fissure program • Presuming that sealants are the main means to prevent caries, the effectiveness of the program among 7 -8 year-old is 1: 8, 62 • Presuming that sealants are the main means to prevent caries, the effectiveness of the program among 12 year-old is 1: 12, 8 • teeth of more than 8 children should be sealed for one kid to avoid caries among 7 -8 year-old • teeth of more than 12 children should be sealed for one kid to avoid caries among 12 year-old

Conclusions by independent agency for health care evaluation Pit and fissure program implemented in Lithuania in August 2004 – September 2007 prevented from caries 19 -31, 8 thousand children aged 7 -13. Taking into account the results of the program in 2004 -2007 it was expected that continuation of the program in 2008 -2009 will decrease caries for 28 -47 thousand children (10 -17 % of all 7 -13 population). Program did not ensure equal participation opportunities, it had no clear goals set at the beginning, costs and utility ration is unacceptable. Program had a economic and social effect. It is advised to continue the program, including monitoring of the results every 2 -3 years via epidemiological surveys. Program’s funds should also be used to promote healthy lifestyle, teaching of oral hygiene and use of topical fluoride.