AMRITA SCHOOL OF DENTISTRY

1. Effectiveness of the
School-Based Oral
Prevention Programs
(Sealants)
Seminar 20

2. CONTENTS
1 2 3 4 5
Introduction History
2
Dental
Sealants
Uses and
Types of
Sealants
Sealant
Materials

3. 6 7 8 9 10
School-Based
Dental Sealant
Programs
Evidences
3
Recommendati
ons
Conclusion References
CONTENTS

4. 4
• Dental sealants are thin coatings that when painted on the chewing surfaces of the back teeth (molars) can prevent cavities for many
years.
• School-age children (ages 6-11) without sealants have almost 3 times more 1st molar cavities than those with sealants.
• Although the overall number of children with sealants has increased over time, low-income children are 20% less likely to have them
and 2 times more likely to have untreated cavities than higher-income children.
INTRODUCTION
Source: https://www.cdc.gov/vitalsigns/dental-sealants/index.html

5. 5
HISTORY
Wilson
(1895)
proposed
application
of zinc
phosphate
Hyatt (1923)
proposed
“prophylactic
odontotomy”.
Bodecker
(1929)
proposed
“fissure
eradication”.
Klein and
Knutson (1942)
proposed
application of
ammonical silver
nitrate
Buonocore
(1955)
proposed filling
the pit and
fissure areas
with bonded
resin.
Development
of
cyanoacrylates
as sealants in
mid 1960s by
Cueto.

6. 6
Bowen (1965)
reported the
development
of BIS-GMA.
Pit and fissure
sealants were
recognized by
ADA (1971)
Simonson
(1978)
proposed PRR
Garcia –
Godoy (1986)
proposed
Preventive GI
sealants
Fiegal (1993)
was the first
to advocate
the use of
bonding
agents
Brown and
Selwitz
introduced
Fluoride
releasing
sealants

7. 7
• Sealants are thin coatings painted on teeth to protect them from cavities.
They flow into the deep grooves of teeth and harden immediately so a
child is able to chew right away.
• Sealants prevent the most cavities when applied soon after permanent
molars come into the mouth (around age 6 for 1st molars and age 12
for 2nd molars).
• Sealants can be applied by a dentist, dental hygienist, or other
qualified dental professional, depending on state law and regulations.
and regulations. This can be done in dental offices or using portable
dental equipment in community settings like a school.
WHAT ARE SEALANTS?

8. 8
• Sealants are a quick, easy, and painless way to prevent most of the
cavities children get in the permanent back teeth, where 9 in 10
cavities occur.
• Once applied, sealants protect against 80% of cavities for 2 years
and continue to protect against 50% of cavities for up to 4 years.
to 4 years.
• Sealants can eliminate the need for expensive and invasive treatments
like dental fillings or crowns.
WHY USE SEALANTS?

9. 9
TRENDS IN CARIES AND SEALANTS

10. 10
CLASSIFICATION OF SEALANT MATERIALS

11. 11
Source: Naaman R, El-Housseiny AA, Alamoudi N. The Use of Pit and Fissure Sealants—A Literature Review. Dentistry Journal. 2017; 5(4):34.
QUALITY OF EVIDENCE ON SEALANT MATERIAL

12. 12
Source: Naaman R, El-Housseiny AA, Alamoudi N. The Use of Pit and Fissure Sealants—A Literature Review. Dentistry Journal. 2017; 5(4):34.
TYPES OF SEALANT MATERIALS

13. 13
Source: Naaman R, El-Housseiny AA, Alamoudi N. The Use of Pit and Fissure Sealants—A Literature Review. Dentistry Journal. 2017; 5(4):34.

14. 14
SBSP are highly effective strategies for preventing tooth decay in children. School-based sealant programs provide pit and fissure
sealants to children in a school setting, and school-linked programs screen the children in school and refer them to private dental
practices or public dental clinics that place the sealants.
School-Based Dental Sealant Programs:
School-based and school-linked programs generally target vulnerable populations that may be at greater risk for developing decay and
less likely to receive dental care.
When developing, coordinating, and implementing a SBSP, state oral health program strategies should
•Use evidence-based practices.
•Promote policies that allow the use of dental personnel to the top of their licensure.
•Develop referral networks.
•Increase efficiency.
SCHOOL-BASED AND SCHOOL-LINKED DENTAL SEALANT PROGRAMS
(SBSP)

15. 15
Data collection and analysis. CDC has developed software (SEALS) that can assist sealant programs in
their data efforts.
CDC grantee states are required to report the following measures related to SBSP coverage annually:
•Percentage of eligible schools with a school-based/linked sealant program.
•Percentage and number of children attending these schools receiving at least one permanent
by grade and age.
CDC grantee states are required to report the following measures related to SBSP effectiveness
•Percentage of children with caries experience.
•Percentage of children with untreated decay.
•Percentage of children without sealants at screening.
•Number of molar sealants placed.
•Percentage of children referred for dental treatment.
•Percentage of children with referrals for urgent dental treatment.

16. 16
Dental Sealants in Schools
• School sealant programs are a highly effective way to deliver sealants to children who are less
• Programs that deliver sealants to children at high risk for tooth decay also save money. Each
in dental treatment costs.
• Applying sealants in schools to the nearly 7 million low-income children who don’t have them
could prevent more than 3 million cavities and save up to $300 million in dental treatment costs.
• CDC currently funds 20 states and one territory to support basic oral health program
sealant programs.
CDC-Funded Programs
Additionally, under the Prevention and Control of Chronic Disease and Associated Risk Factors in the
U.S. Affiliated Pacific Islands, U.S. Virgin Islands, and Puerto Rico (DP-1901) Cooperative Agreement,
Puerto Rico receives an annual award of $150,000 to develop and implement an oral health
surveillance plan, as well as to implement, promote, and evaluate school sealant programs.

17. 17
Recommendation: Fontana, M. et al, Techniques for Assessing Tooth Surfaces in School-Based Sealant Programs, JADA 2010.

18. 18
Initiation of the Pit and
Fissure Sealant Pilot Project
in 2017 in collaboration with
12 dental colleges and
institutes with a target to seal
53,750 permanent molars in
children 6-14 years of age to
prevent dental caries.

19. 19
J Dent Res 87(2):169-174, 2008

20. 20

21. 21

22. 22

23. 23
Findings of this meta-analysis proved there is
no significant difference between PFS and FV in
caries prevention efficacy of FPMs at 2 years’
follow-up, emphasizing the use of FV since it is
more affordable and easier to apply.

24. 24

25. 25

26. 26

27. 27

28. 28

29. 29

30. 30

31. 31

32. 32

33. 33
The Federal government is
• Classifying pediatric dental services as an
essential health benefit to be covered by dental
insurance as part of the Affordable Care Act.
• Matching state costs for applying dental
sealants for all children enrolled in
Medicaid/CHIP and tracking program
performance.
• Encouraging community health centers with
dental programs to start or expand school-
based sealant programs to help more low-
income children.
• Helping fund states to increase the number of
dental sealant programs.
• Providing incentives for dentists to practice in
under-served areas to increase access to
dental services.
State officials can
• Target school-based sealant programs to the
areas of greatest need. Track the number of
schools and children participating in sealant
programs.
• Implement policies that deliver school-based
sealant programs in the most cost-effective
manner.
• Help schools connect to Medicaid and CHIP,
local health department clinics, community
health centers, and dental providers in the
community to foster more use of sealants and
reimbursement of services.
WHAT CAN BE DONE ?

34. 34
Dental care providers can
• Apply sealants to children at highest
risk of cavities, including those
covered by Medicaid/CHIP. Donate
time and resources to a school-based
dental sealant program.
• Learn about school-based dental
sealant programs and their
effectiveness.
• Accept children into their practice who
are identified as needing more
services when they receive sealants
in schools.
School administrators can
• Work with the local or state public
health programs and local dental
providers to start school-based
sealant programs.
• Support having sealant programs in
schools and promote its benefits to
teachers, staff, and parents. Help
children enroll in sealant programs by
putting information for parents in
registration packets in the beginning
of the school year.
• Encourage schools to develop
relationships with local dental offices
and community dental clinics to help
children get dental care.

35. CONCLUSION
35
• The evidence shows that sealants benefit is
inclusive to both sound occlusal surfaces and
non-cavitated occlusal carious lesions.
• In addition, sealant use should be increased
along with other preventive interventions to
manage the caries disease process, especially
in patients with an elevated risk of developing
caries.
• School-based interventions can be effective in
reducing the burden of oral disease among
primary school children in LMICs.

36. 36
• https://www.cdc.gov/oralhealth/funded_programs/preventive-interventions/school.htm
• Community Preventive Services Task Force. Preventing Dental Caries: School-Based Dental Sealant Delivery Programs website. www.thecommunityguide.org/oral/schoolsealants.html . Accessed
October 12, 2016.
• Griffin SO, Naavaal S, Scherrer CR, 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.
• Griffin SO, Wei L, Gooch B, Weno K, Espinoza L. Changes in dental sealant and untreated tooth decay prevalence and the estimated impact of increasing school-based sealant program coverage.
MMWR. 2016;65:1141-1145.
• Griffin SO, Barker LK, Wei L, Chien-Hsun L, Albuquerque MS, Gooch BF. Use of dental care and effective preventive services in preventing tooth decay among US children and adolescents—Medical
Expenditure Panel Survey, United States, 2003–2009 and National Health and Nutrition Examination Survey, United States, 2005–2010. MMWR. 2014;63(2):55–61.
• Ahovuo-Saloranta A, Hiiri A, Nordblad A, Worthington H, Makela M -2004-. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database
Syst Rev 3:CD001830.
• Kolavic Gray S, Griffin SO, Malvitz DM, Gooch BF. A comparison of the effects of toothbrushing and handpiece prophylaxis on retention of sealants. J Am Dent Assoc. 2009 Jan;140(1):38-46. doi:
10.14219/jada.archive.2009.0016. Erratum in: J Am Dent Assoc. 2009 Nov;140(11):1352. PMID: 19119165.
• Tahani B, Asgari I, Saied Moallemi Z, Azarpazhooh A. Fissure sealant therapy as a portable community‐based care in deprived regions: Effectiveness of a clinical trial after 1 year follow‐up. Health &
Social Care in the Community. 2021 Sep;29(5):1368-77.
• Muller‐Bolla M, Lupi‐Pégurier L, Bardakjian H, Velly AM. Effectiveness of school‐based dental sealant programs among children from low‐income backgrounds in F rance: a pragmatic randomized
clinical trial. Community Dentistry and Oral Epidemiology. 2013 Jun;41(3):232-41.
• Patel N, Griffin SO, Linabarger M, Lesaja S. Impact of school sealant programs on oral health among youth and identification of potential barriers to implementation.
The Journal of the American Dental Association. 2022 Oct 1;153(10):970-8.
REFERENCES

37. THANK YOU