title: Effectiveness of sealant treatment over five years in an insured population.
abstract: BACKGROUND
  The authors analyzed an insurance claim database to evaluate the use and effectiveness of placing sealants on first and second permanent molars of children in private dental practices.
  
  
  METHODS
  A retrospective study was conducted using an insured population with sealant coverage at 70 percent of the usual fee in a preferred provider organization than that limited reapplication to once every three years. Children were selected who were eligible for sealant benefits from July 1, 1990, to June 30, 1991. Two groups were selected for analysis, based on age, as determined by permanent molar eruption dates. Children who received sealants were compared with those who did not to determine post-sealant restorative outcomes after five years.
  
  
  RESULTS
  During the full year of coverage, sealants were used in only 16.3 percent of first permanent molars and 11.6 percent of second permanent molars. The five-year incidence of an occlusal restoration having been placed was 13.7 percent and 20.8 percent, respectively, on nonsealed first and second molars and 6.5 percent and 10.4 percent, respectively, on sealed first and second molars. From years three to five, sealant placement provided only nominal additional preventive effect.
  
  
  CONCLUSIONS
  In the population selected, both the incidence of occlusal caries and the use of sealants were lower than expected for both age groups. However, within these groups, molar occlusal surfaces were only half as likely to have been restored in sealed teeth than in nonsealed teeth after five years.
  
  
  CONCLUSIONS
  Based on the five-year data from a population with a low incidence of caries, the authors found that 15 sealed first permanent molars or 10 sealed second permanent molars prevented placement of one occlusal restoration. Therefore, sealants are more effective when placed in patients with risk factors for occlusal caries.
authors.affiliation: Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor 48109, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Dennison
authors.forename: L H
authors.initials: LH
authors.lastname: Straffon
authors.forename: R C
authors.initials: RC
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000517:prevention & control; D019229:Dentition, Permanent; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007347:Insurance, Dental / Q000706:statistics & numerical data*; D008824:Michigan; D008963:Molar; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D010895:Pit and Fissure Sealants