Sealant application on children and adolescents has increased from 19.6% to 32.2% from 1988 to 2002. Even with this increase, the sealant usage objective listed by Healthy People 2010 is 50% as part of its initiative to promote health and prevent disease. Dental decay is the most prevalent disease in children. Sealants can be effective as a way to avoid pain, infections, and tooth loss in this population. Sealants can be 100% effective if applied correctly and when teeth are fully erupted, first molars at age 5 to 6 and second molars at about age 15. Checking the retention of sealants should be done at each dental recall appointment, and repair or reapplication done when needed. Research has shown sealants are effective even when applied over incipient decay. Sealant useage is linked to socioeconomic and ethnic considerations. Caucasian children were found to have lower levels of decay than other populations due to sealant placement. Sealants can also be helpful when placed on adults with xerostomia. Difficulties exist in treating those in lower socioeconomic groups because of the reduced number of dentists who accept Medicaid due to low reimbursement rates and lack of dental insurance coverage for the procedure. Fluoridation of water supplies has reduced smooth surface decay rates for children and adolescents, but that delivery system does not prevent decay in grooves and pits on molar and premolar teeth. Sealant materials pose minimal risks to children, and no toxicity has been found to prevent the procedure. Sealant material can contain filled or unfilled resins, and some with amorphous calcium phosphate have the potential to prevent future decay. Sealants containing fluoride also prevent decay. Materials can be colored or colorless and can be applied to wet or dry surfaces. More work must be done and education provided to parents to increase the awareness of how dental sealants can prevent dental caries.
(Source: Dimensions of Dental Hygiene, February 2007)
