Dental sealants are thin plastic coatings
that are applied to the pits and fissures
(grooves) on the chewing surfaces of molar
teeth. Most tooth decay experienced by
children and adolescents occurs on these
surfaces. Sealants prevent dental caries (tooth
decay) by creating a physical barrier against
bacterial plaque and food.
PreventingTooth Decay
Dental caries (tooth decay) prevention
in children and adolescents
involves a range of population- and
individual-level strategies that may
include dental sealants, community
water fluoridation, topical fluorides
(e.g., fluoride toothpaste, fluoride
varnish), antibacterial rinses, education,
and dietary interventions.
Dental sealants are an effective
tool in both preventing caries and
stopping the progression of early
caries (noncavitated lesions). Placing
dental sealants on the chewing
surfaces of molars with early signs of
decay significantly lowers the probability
that the decay will progress,
compared with the progression for
similar teeth that have not been
sealed. "is benefit may last as long
as 5 years
Access to Care
Since 2000, the prevalence of dental
sealants among 8-year-old children
and 14-year-old adolescents
has increased, although it remains
substantially below the Healthy People
national objective target prevalence of 50 percent for both ages.
Factors contributing to the increased prevalence of dental sealants among children from families
with low incomes may include Medicaid reimbursement rates and the provision of sealants
in school-based oral health programs.
School-based dental sealant programs are an important
and effective public health approach that complements
clinical care systems in promoting the oral health of
children and adolescents.
Dental sealant programs typically target students in
second grade, when the first permanent molars have
generally erupted, and in sixth grade, when the second
permanent molars have generally erupted.
Disparities in Care
and adolescents have a significantly lower prevalence of
dental sealants than non-Hispanic white children and
adolescents.
Children and adolescents from families with low
incomes (less than 200 percent of the federal poverty
level) are more than twice as likely to have untreated
dental caries (tooth decay) in their permanent teeth as
are their higher-income counterparts.
Children and adolescents from families with low incomes are almost 50 percent less likely to
have received dental sealants than their higher-income counterparts.
Public Awareness
Increased public awareness of dental
sealants, and improved communication
between parents and oral health professionals,
will help parents make informed
decisions about dental sealant applicationfor their children and adolescents.
Racial and ethnic minorities and individuals
with low levels of formal education
and low incomes are least knowledgeable
about oral disease prevention, including
the effectiveness of dental sealants.
Because they lack insurance or access to
preventive services, children and adolescents
from these groups have fewer dental
visits and fewer dental sealants.
Cost-Effectiveness
Dental sealants are most cost-effective
when provided to children and adolescents
who are at highest risk for dental caries.
School-based dental sealant programs
have been proven to reduce oral health
disparities in children and adolescents by
providing this cost-effective preventive
strategy to those who are at highest risk
for dental caries.
Programs Based on a systematic review of evidence documenting the effectiveness of population-basedinterventions to prevent and control tooth decay, the Task Force on Community Preventive
Services strongly recommended school-based or school-linked pit-and-fissure sealant delivery
programs.
Ohio’s targeted school-based dental sealant programs
effectively reach children at high risk for tooth decay.
Targeted schools are those in which at least 40 percent
of students are enrolled in the Free and Reduced Price
Meal Program (students from families with incomes of
185 percent or less of the federal poverty level).
To help build more effective state, territorial, and community
oral health programs, the Association of State
and Territorial Dental Directors initiated the Best Practices
Project, which includes examples of proven and
promising school-based dental sealant programs.
Dental sealant programs are an important component
of, and should be linked with, broader systems of care.
School-based dental sealant programs are one component
of a broader system of care and, as such, should
coordinate and have linkages with other system components,
especially dental homes.
