Increasing Dental Sealant Use to Prevent Tooth Decay in Children

Tooth decay continues to be one of the most common chronic diseases of children and adolescents in the United States. By age 17, nearly 70% of adolescents have had tooth decay; most of the decay occurs in the pits and fissures of the back teeth. Children from low-income homes are about 20% more likely to have tooth decay than children living in higher income (> 200 percent of the federal poverty level) families. Tooth decay can lead to pain and infection as well as problems in learning.

Dental sealants prevent about 80% of the decay in the back teeth. Sealants are plastic coatings placed on the grooves of the chewing surfaces of teeth to keep decay-causing bacteria and food particles from collecting in the pits and fissures. Factors associated with children not having sealants include parents’ inability to pay for dental care (e.g., low family income or lack of dental insurance) and personal characteristics that influence parents’ acceptance of sealants, such as low parent education and low health literacy.

Our recent report, which used 3 cycles of data from the National Health and Nutrition Examination Survey, looked at the combined effect of parent education and income on receipt of sealants by children. We found that higher family income was associated with higher sealant prevalence among children with more highly educated parents (> high school education) but not among less educated parents (< high school education).

Recent health care reforms are expected to increase access to dental insurance. School-based dental sealant programs, recommended by the Community Preventive Services Task Force based on strong evidence of effectiveness, also remove financial and travel barriers in receipt of sealants. Our findings suggest that the impact of these policies and programs on sealant prevalence will be greater among children of better educated parents. Although it would be very difficult to increase parent education in the short term, oral health literacy campaigns may increase the impact of these policy and programmatic efforts to ensure that parents understand the preventive benefits of dental sealants.

Additional resources

• CDC Guidelines for School Sealant Programs
• CDHP‘s Sealant Report
• Community Preventive Services Task Force

By Susan O. Griffin, PhD

Health Economist, Division of Oral Health

National Center for Chronic Disease Prevention and Health Promotion

Centers for Disease Control and Prevention