The Benefits and Impact of School-Based Sealant Programs
The Benefits and Impact of School-Based Sealant Programs
What are dental sealants and how do they work?
Dental sealants are thin coatings applied to the chewing surfaces of back teeth including molars and premolars. They can be clear or opaque in appearance. Their main function is to prevent cavities as cavities are most likely to develop in those groove or pit areas.1 These protective barriers work by sealing (closing off) deep grooves and pits in the teeth, making it harder for food particles and bacteria to accumulate. The application process is quick, painless, and highly effective. Dental sealants have been shown to provide long-term protection against decay. They are particularly beneficial for children and teenagers, as their newly erupted permanent teeth are the most susceptible to cavities. The first permanent molars typically erupt at around 6 years of age, and the second permanent molars typically erupt at around 12 years of age. Dental sealants can also be applied to primary (baby) teeth for cavity prevention.2
According to the CDC (U.S. Centers for Disease Control and Prevention), sealant can prevent up to 80% of cavities for 2 years, and up to 50% of cavities in 4 years.2 It is worth noting that among children 6-11 years old, those without dental sealants are nearly 3x more likely to get cavities in their back teeth compared to those with dental sealants. Therefore, this preventive measure is particularly beneficial for children who may not have regular access to dental care or who may be at higher risk for cavities. Dental sealants can provide them with a protective barrier against tooth decay and reducing the need for future, more invasive, and more costly dental treatments.2
Research & evidence supporting school-based sealant programs
School-based sealant programs have been extensively researched and proven effective. Apart from measuring the percentage of cavities prevented (discussed above), another way to analyze the effects of school-based dental sealant programs is to measure the dollars saved by sealing children’s teeth. For example, in a report from Community Guide in 2016 showed that for every tooth sealed, the cost saved in preventing future dental treatment was more than $11 per tooth.3 Since dental sealants can be applied outside of traditional dental offices using mobile equipment and staffing, this cavity prevention strategy is especially useful among children and families who may not have reliable or regular access to dental care. More specifically, in a school-based sealant program, the sealant may be applied by qualified dental professionals using mobile equipment directly in a school classroom setting.2 With strong supporting evidence available, the Community Preventive Services Task Force (CPSTF) recommends school-based sealant programs to deliver dental sealants to children for the purpose of preventing dental decay.4
Reducing oral health disparity and expanding school-based sealant programs
Oral health disparities remain a significant concern among U.S. children and adults, with low-income and minority children experiencing higher rates of dental disease (also known as oral disease burden). The CDC reports that approximately 60% (3 in 5 children) of children 6-9 years old from lower income households had cavities, which is significantly higher than 40% of children (2 in 5 children) compared to those from higher income households. In a similar pattern, there were a higher percentage of untreated cavities among adolescents from lower income households (14%) compared to those from higher income households.5
School-based sealant programs are instrumental in addressing these disparities by providing preventive care directly in schools, thereby reducing the gap in dental health outcomes. These programs contribute to achieving oral health equity by ensuring that all children, regardless of socioeconomic background, have access to essential dental care. In doing so, they reduce the burden of untreated dental issues, which can negatively impact school performance, nutrition, and overall well-being.6
Over the past few decades, school-based sealant programs have expanded in response to growing awareness of oral health disparities. Many states and local health departments, with support from the CDC and other health organizations, have implemented these programs in public schools, particularly those serving a high percentage of low-income students. Sometimes these programs work with school that have a higher percentage of children who are eligible for free or reduced meal programs.6 The Affordable Care Act (ACA) also supports preventive services like dental sealants, helping increase access to these programs across the country. Additionally, states have adopted policies to improve program funding and increase participation among students in need. This means sealants are covered by most dental insurances and some medical insurances including Medicaid. 1,7
Healthy People 2030, a national initiative by the U.S. Department of Health and Human Services, sets key objectives for improving health outcomes, including oral health. One of its primary goals is to increase the proportion of children and adolescents receiving preventive dental services, including sealants. School-based sealant programs directly support this objective by increasing access to preventive care, reducing the prevalence (occurrence) of dental cavities, and ultimately improving the overall oral health of children.8
With continued support from public health organizations, policymakers, and dental professionals, school-based sealant programs are positioned to expand further. Ongoing research and funding initiatives aim to strengthen these programs and making them more accessible and effective in reaching underserved communities. Advances in technology and policy efforts to integrate dental services within school health initiatives will also play a crucial role in sustaining and growing these programs.
Backed by research and supported by leading health organizations like the CDC and NIDCR (National Institute of Dental and Craniofacial Research), these programs continue to be a vital strategy in preventive dentistry. As they align with national health goals, such as those outlined in Healthy People 2030, their expansion will further promote oral health equity, ensuring that every child can maintain a healthy smile. Investing in these programs is a crucial step toward a future where dental disease is no longer a barrier to a child's overall health and well-being.
Related topics: oral health disparity, Healthy People 2030, oral health equity, health equity
References
1. Association of State & Territorial Dental Directors. Best Practice Approach: School-Based Dental Sealant Programs. Accessed February 26, 2025. https://www.astdd.org/bestpractices/school-based-dental-sealant-programs-bpar-2022-final.pdf
2. CDC. About Dental Sealants. Oral Health. September 18, 2024. Accessed February 26, 2025. https://www.cdc.gov/oral-health/prevention/about-dental-sealants.html
3. Griffin SO, Naavaal S, Scherrer C, Patel M, Chattopadhyay S. Evaluation of School-Based Dental Sealant Programs: An Updated Community Guide Systematic Economic Review. Am J Prev Med. 2017;52(3):407-415. doi:10.1016/j.amepre.2016.10.004
4. Cavities: School-Based Dental Sealant Delivery | The Community Guide. May 19, 2023. Accessed February 26, 2025. https://www.thecommunityguide.org/findings/dental-caries-cavities-school-based-dental-sealant-delivery-programs.html
5. CDC. Health Disparities in Oral Health. Oral Health. October 17, 2024. Accessed February 26, 2025. https://www.cdc.gov/oral-health/health-equity/index.html
6. CDC. School Sealant Programs. Oral Health. September 18, 2024. Accessed February 26, 2025. https://www.cdc.gov/oral-health/php/school-dental-sealant-programs/index.html
7. Dental Sealants | National Institute of Dental and Craniofacial Research. Accessed February 26, 2025. https://www.nidcr.nih.gov/health-info/dental-sealants
8. Healthy People 2030 | odphp.health.gov. Accessed February 26, 2025. https://odphp.health.gov/healthypeople
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