Rozier leads CDC work group recommending school-based dental sealant programs

Dr. Gary Rozier

School-based sealant programs are an effective public health approach to preventing caries, according to a November cover story in The Journal of the American Dental Association. The article is based on recommendations developed by a Centers for Disease Control and Prevention work group led by Gary Rozier, DDS, MPH, UNC Gillings School of Global Public Health professor of health policy and management and director of the Dental Public Health Program.

“Sealants — a thin plastic coating applied to the chewing surfaces of the back teeth — are a major public health intervention that is underutilized,” Rozier said. “They can be used to reduced dental disease in high-risk children, the most common disease of childhood, and help eliminate large disparities in oral health.”

Dental sealant programs typically target schools that serve large populations of low-income children and focus on sealing newly erupted permanent molar teeth. They work in collaboration with local dentists, dental associations, school nurses, administrators, public health clinics and parents. The new recommendations are designed to assist state and community oral health programs interested in implementing their own programs and also to assist private practitioners who collaborate with and advocate for public health programs.

Nationally, only one in five children from low-income families currently have sealants, far short of Healthy People 2010 national objectives, the article states. Low-income children are nearly twice as likely to have decay in their permanent teeth. According to recent national estimates of health care expenditures, dental disease equals heart disease as the most costly of all health conditions.

The new recommendations provide guidance regarding planning, implementing and evaluating sealant programs. They state that programs:

• should seal pit-and-fissure tooth surfaces that are sound or have early decay, prioritizing first and second permanent molars;
• should use visual assessment to differentiate surfaces with the earliest signs of tooth decay from more advanced lesions;
• consider a toothbrush prophylaxis as an acceptable method to clean the tooth surface before preparing the tooth for sealant material with acid etching;
• should use four-handed technique to place sealants, when resources allow.

The recommendations also say that school-based sealant programs can “connect participating students with sources of dental care in the community and enroll eligible children in public insurance programs.”

For additional resources on sealants, visit http://www.cdc.gov/OralHealth/topics/dental_sealant_programs.htm.

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UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.