Preventing Tooth Decay and Saving Teeth 

with Dental Sealants

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.1
2

Preventing 

Tooth Decay

Access to Care

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.2

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.3,4

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.2

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.5

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.6

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.2

Non-Hispanic black and Mexican-American children 

and adolescents have a significantly lower prevalence of 

dental sealants than non-Hispanic white children and 

adolescents.2,7

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. 4,7

Children and adolescents from families with low incomes are almost 50 percent less likely to 

have received dental sealants than their higher-income counterparts.4

Disparities 

in Care
3

Cost-Effectiveness Dental sealants are most cost-effective 

when provided to children and adolescents 

who are at highest risk for dental caries.10

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.10

Programs Based on a systematic review of evidence documenting the effectiveness of population-based 

interventions 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.11

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).12–14

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.15

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.16

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 application 

for their children and adolescents.8

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.8,9

Because they lack insurance or access to 

preventive services, children and adolescents from these groups have fewer dental 

visits and fewer dental sealants.8
4

1. Centers for Disease Control and Prevention. 2009. Frequently Asked Questions. Dental 

Sealants. In Centers for Disease Control and 

Prevention [Web site]. http://www.cdc.gov/

oralhealth/publications/factsheets/sealants_

faq.htm.

2. Tomar SL, Reeves AF. 2009. Changes in the 

oral health of U.S. children and adolescents 

and dental public health infrastructure since 

the release of the Healthy People 2010 objectives. Academic Pediatrics 9(6):388–395. http://

download.journals.elsevierhealth.com/pdfs/

journals/1876-2859/PIIS1876285909002678.

pdf.

3. Beauchamp BJ, Caufield PW, Crall JJ, Donly 

K, Feigal R, Gooch B, Ismail A, Kohn W, 

Siegal M, Simonsen R; American Dental Association, Council on Scientific Affairs. 2008. 

Evidence-based clinical recommendations for 

the use of pit-and-fissure sealants: A report 

of the American Dental Association, Council 

on Scientific Affairs. Journal of the American 

Dental Association 139(3):257–268. http://jada.

ada.org/cgi/content/abstract/139/3/257.

4. Griffin SO, Oong E, Kohn W, Vidakovic B, 

Gooch BF; CDC Dental Sealant Systematic 

Review Work Group, Bader J, Clarkson J, 

Fontana MR, Meyer DM, Rozier RG, Weintraub JA, Zero DT. 2008. #e effectiveness of 

sealants in managing caries lesions. Journal of 

Dental Research 87(2):169–174. http://www.

ncbi.nlm.nih.gov/pubmed/18218845.

5. Griffin SO, Jones KA, Lockwood S, Mosca 

NG, Honoré PA. 2007. Impact of increasing 

Medicaid dental reimbursement and implementing school sealant programs on sealant 

prevalence. Journal of Public Health Management and Practice 13(2):202–206. http://

journals.lww.com/jphmp/Fulltext/2007/030

00/Impact_of_Increasing_Medicaid_Dental_

Reimbursement.19.aspx.

6. Gooch BF, Griffin SO, Gray SK, Kohn WG, 

Rozier RG, Siegal M, Fontana M, Brunson D, 

Carter N, Curtis DK, Donly KJ, Haering H, 

Hill LF, Pitts Hinson H, Kumar J, Lampiris 

L, Mallatt M, Meyer DM, Miller WR, SanziSchaedel SM, Simonsen R, Truman BI, Zero 

DT. 2009. Preventing dental caries through 

school-based sealant programs: Updated 

recommendations and reviews of evidence. 

Journal of the American Dental Association

140(11):1356–1365. http://jada.ada.org/cgi/

content/short/140/11/1356.

7. Dye BA, Tan S, Smith V, Lewis BG, Barker 

LK, #ornton-Evans G, Eke PI, BeltránAguilar ED, Horowitz AM, Li CH. 2007. 

Trends in oral health status: United States, 

1988–1994 and 1999–2004. Vital and Health 

Statistics 11(248):1–92.

8. Gilpin JL. 1997. Pit and fissure sealants: 

A review of the literature. Journal of Dental 

Hygiene 71(4):150–158.

9. Jones K, Griffin S, Moonesinghe R, Jaramillo 

F, Vousden C. 2005. Reducing dental sealant 

disparities in school-age children through 

better targeting of informational campaigns. 

Preventing Chronic Disease: Public Health 

Research, Practice, and Policy 2(2). http://www.

cdc.gov/pcd/issues/2005/apr/04_0142p.htm.

10. Maternal and Child Health Advisory Board. 

2009. Dental Sealants. Carson City, NV: 

Nevada State Health Division, Oral Health 

Initiative. http://health.nv.gov/PDFs/

MCHAB/Dental_Sealants.pdf.

11. Centers for Disease Control and Prevention. 

2001. Promoting oral health: Interventions for 

preventing dental caries, oral and pharyngeal cancers, and sports-related craniofacial 

injuries. Morbidity and Mortality Weekly Report 

Recommendations and Reports 50(RR 21):1–13. 

http://www.cdc.gov/mmwr/preview/mmwr

html/rr5021a1.htm.

12. Siegal MD, Detty AM. 2010. Do schoolbased dental sealant programs reach higher 

risk children? Journal of Public Health Dentistry 

70(2):140–147. http://onlinelibrary.wiley.com/

doi/10.1111/j.1752-7325.2009.00162.x/pdf.

13. Ohio Department of Health, Bureau of Oral 

Health Services. 2009. School-Based Dental 

Sealant Program Manual. Columbus, OH: 

Ohio Department of Health, Bureau of Oral 

Health Services. http://www.odh.ohio.gov/

ASSETS/AE87CDD4956643F5A54853F3

BAD600A4/Manual%20with%20active%20

linksFINAL.pdf.

14. US Department of Agriculture, Food and 

Nutrition Service. 2009. Child Nutrition Programs—Income Eligibility Guidelines. Federal 

Register 74(58):13410–13412. http://www.fns.

usda.gov/cnd/governance/notices/iegs/iegs.

htm.

15. Association of State and Territorial Dental 

Directors. 2003. Best Practice Approach Report: 

School-Based Dental Sealant Programs. Sparks, 

NV: Association of State and Territorial 

Dental Directors. http://www.astdd.org/index.

php?template=bestpracschoolsealant.php.

16. Zimmerman B. 2006. Improving the Oral 

Health of School-Aged Children: Strengthening 

School-Based Dental Sealant Program Linkages 

with Medicaid/SCHIP and Dental Homes—

Summary of an Expert Meeting Convened by the 

Maternal and Child Health Bureau. Washington, 

DC: Health Systems Research. http://www.

mchoralhealth.org/PDFs/SealantsMedicaid

DentalHome.pdf.

Holt K, Barzel R. 2010. Preventing Tooth Decay 

and Saving Teeth with Dental Sealants (3rd ed.). 

Washington, DC: National Maternal and Child 

Oral Health Resource Center.

#is publication was made possible by grant 

number H47MC00048 from the Maternal and 

Child Health Bureau, Health Resources and 

Services Administration, U.S. Department of 

Health and Human Services.

Preventing Tooth Decay and Saving Teeth with 

Dental Sealants (3rd ed.) © 2010 by the National 

Maternal and Child Oral Health Resource 

Center, Georgetown University.

Permission is given to photocopy this publication 

or to forward it, in its entirety, to others. Requests 

for permission to use all or part of the information 

in contained in this publication in other ways 

should be sent to the National Maternal and 

Child Oral Health Resource Center.

National Maternal and Child Oral Health 

Resource Center

Georgetown University

Box 571272

Washington, DC 20057-1272

	
t	
GBY

E-mail: OHRCinfo@georgetown.edu

Web site: http://www.mchoralhealth.org

References