School Sealant Programs

School sealant programs are an effective way to reach millions of children with dental sealants to prevent cavities. The Community Preventive Services Task Force strongly recommendsexternal icon using school-based sealant delivery programs to prevent cavities among children.¹ In addition, school sealant programs can be cost-saving within 2 years of placing sealants, and delivering sealants to children at high risk for cavities can be cost-saving to Medicaid.²

CDC supports states to put into action school sealant programs that reduce oral disease and improve oral health. As part of CDC’s State Actions to Improve Oral Health Outcomes (DP-1810), CDC funds 20 states and one territory for implementing evidence-based preventive interventions to include expanding sealant delivery in low-income and rural schools.

Overview

School sealant programs provide pit and fissure sealants to children using portable equipment in a school setting. Although each state-coordinated program may be different in how they structure their program, generally speaking, school sealant programs focus on providing sealants to children aged 6 to 11 years or in grades 1 through 5. A typical sealant program will visit an individual school over the course of 1 to 3 days. A licensed dental professional will screen children for oral disease. They also check to see if the children already have sealants, and if so, how well those sealants are being retained. Children with a signed permission slip from their parents or guardians who do not have dental sealants will get them applied, typically at no cost. Any child that needs additional follow-up care will get a referral to a local dentist.

School sealant programs are especially important for reaching children who are at greater risk for developing cavities and less likely to receive private dental care. Programs generally target schools with a higher percentage of children eligible for federal free or reduced-cost meal programs.

Compared with children from higher income families, children from low-income families are more likely to:

• Have untreated tooth decay.³
• Have few or no dental sealants.³
• Not have had yearly dental visits.⁴

Ways to Increase Sealant Use

There are many actions that states, dental providers, schools, and parents can take to increase sealant prevalence.

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 underserved 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 the Children’s Health Insurance Program (CHIP), local health department clinics, community health centers, and dental providers in the community to encourage more use of sealants and reimbursement of services

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.

Parents can

• Ask your child’s dentist to apply sealants when appropriate.
• Sign your child up to participate in a school-based sealant program. If your school does not have sealant program, ask them to start one.
• Find a dentist if your child needs one. Use the Insure Kids Now Dentist Locatorexternal icon to find a dentist that takes Medicaid and CHIP.

Additional Resources

• CDC Vital Signs website Dental Sealants Prevent Cavities presents important information for parents, school administrators, dental care providers, state officials, and federal government officials to help increase the use of this valuable tool.
• Oral Health in America: A Report of the Surgeon Generalexternal icon is a US Surgeon General’s report that was the first to focus on oral health and provides an overview on the effectiveness of sealants and public health strategies to provide sealants to children in community settings.
• Dental Sealants: Proven to Prevent Tooth Decayexternal icon is a report published by the Children’s Dental Health Project and based on research funded by CDC that explores the factors that shape school sealant programs’ ability to reach more children in effective and sustainable ways. The report is based on a series of surveys and interviews with stakeholders across the country.

References

1. Community Preventive Services Task Force. Preventing Dental Caries: School-Based Dental Sealant Delivery Programs website. www.thecommunityguide.org/oral/schoolsealants.htmlexternal icon. Accessed October 12, 2016.
2. 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.
3. 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.
4. 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.