title: Preventing dental caries through school-based sealant programs: updated recommendations and reviews of evidence.
abstract: 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.
authors.affiliation: 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
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Gooch
authors.forename: Susan O
authors.initials: SO
authors.lastname: Griffin
authors.forename: Shellie Kolavic
authors.initials: SK
authors.lastname: Gray
authors.forename: William G
authors.initials: WG
authors.lastname: Kohn
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
authors.forename: Mark
authors.initials: M
authors.lastname: Siegal
authors.forename: Margherita
authors.initials: M
authors.lastname: Fontana
authors.forename: Diane
authors.initials: D
authors.lastname: Brunson
authors.forename: Nancy
authors.initials: N
authors.lastname: Carter
authors.forename: David K
authors.initials: DK
authors.lastname: Curtis
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Donly
authors.forename: Harold
authors.initials: H
authors.lastname: Haering
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Hill
authors.forename: H Pitts
authors.initials: HP
authors.lastname: Hinson
authors.forename: Jayanth
authors.initials: J
authors.lastname: Kumar
authors.forename: Lewis
authors.initials: L
authors.lastname: Lampiris
authors.forename: Mark
authors.initials: M
authors.lastname: Mallatt
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Meyer
authors.forename: Wanda R
authors.initials: WR
authors.lastname: Miller
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sanzi-Schaedel
authors.forename: Richard
authors.initials: R
authors.lastname: Simonsen
authors.forename: Benedict I
authors.initials: BI
authors.lastname: Truman
authors.forename: Domenick T
authors.initials: DT
authors.lastname: Zero
mesh_terms: 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
chemical_list: D002327:Cariostatic Agents; D010895:Pit and Fissure Sealants