Preventing dental caries through school-based sealant programs: updated recommendations and reviews of evidence.
BACKGROUND
School-based sealant programs (SBSPs) increase sealant use and reduce caries. Programs target schools that serve children from low-income families and focus on sealing newly erupted permanent molars. In 2004 and 2005, the Centers for Disease Control and Prevention (CDC), Atlanta, sponsored meetings of an expert work group to update recommendations for sealant use in SBSPs on the basis of available evidence regarding the effectiveness of sealants on sound and carious pit and fissure surfaces, caries assessment and selected sealant placement techniques, and the risk of caries' developing in sealed teeth among children who might be lost to follow-up. The work group also identified topics for which additional evidence review was needed.


METHODS
The work group used systematic reviews when available. Since 2005, staff members at CDC and subject-matter experts conducted several independent analyses of topics for which no reviews existed. These reviews include a systematic review of the effectiveness of sealants in managing caries.


RESULTS
The evidence supports recommendations to seal sound surfaces and noncavitated lesions, to use visual assessment to detect surface cavitation, to use a toothbrush or handpiece prophylaxis to clean tooth surfaces, and to provide sealants to children even if follow-up cannot be ensured.


CONCLUSIONS
These recommendations are consistent with the current state of the science and provide appropriate guidance for sealant use in SBSPs. This report also may increase practitioners' awareness of the SBSP as an important and effective public health approach that complements clinical care.
Gooch
Barbara F
BF
Division of Oral Health/Surveillance, Investigations, and Research Branch, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS-F10, Atlanta, Ga. 30341, USA. oralhealth@cdc.gov
Griffin
Susan O
SO
Gray
Shellie Kolavic
SK
Kohn
William G
WG
Rozier
R Gary
RG
Siegal
Mark
M
Fontana
Margherita
M
Brunson
Diane
D
Carter
Nancy
N
Curtis
David K
DK
Donly
Kevin J
KJ
Haering
Harold
H
Hill
Lawrence F
LF
Hinson
H Pitts
HP
Kumar
Jayanth
J
Lampiris
Lewis
L
Mallatt
Mark
M
Meyer
Daniel M
DM
Miller
Wanda R
WR
Sanzi-Schaedel
Susan M
SM
Simonsen
Richard
R
Truman
Benedict I
BI
Zero
Domenick T
DT
D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D003731:Dental Caries / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D003777:Dental Prophylaxis / Q000379:methods; D006801:Humans; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D012571:School Dentistry / Q000592:standards*; D019246:Tooth Preparation / Q000379:methods; D014481:United States
D002327:Cariostatic Agents; D010895:Pit and Fissure Sealants