School-Based Dental Sealant Programs
Sealants prevent tooth decay and also stop cavities from growing. The
report on oral
health indicates that sealants can reduce decay in school children by
more than 70 percent.
On this page:
What Are Dental Sealants?
Sealants are thin plastic coatings applied to the tiny grooves on the
chewing surfaces of the back teeth. This is where most tooth decay in
children and teens occurs. Sealants protect the chewing surfaces from decay
by keeping germs and pieces of food out.
Learn more about sealants, including how they help prevent tooth decay and
how they are applied, from this
Dental Sealants Fact
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What Are School-Based Sealant Programs?
School-based dental sealant delivery programs provide sealants to children
unlikely to receive them otherwise. Such programs—
- Define a target population within a school district
- Verify unmet need for sealants
- Get financial, material, and policy support
- Apply rules for selecting schools and students
- Apply sealants at school or offsite in clinics
School-based sealant programs are especially important for reaching children
from low-income families who are less likely to receive private dental care.
Programs generally target schools by using the percentage of children
eligible for federal free or reduced-cost lunch programs Tooth decay may
result in pain and other problems that affect learning in school-age
children. Learn more by reading
Oral Health and Learning*
(PDF–81K). This report addresses the following:
- Lost school time
- Oral health and learning
- Nutrition and learning
- Programs for improving oral health
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The Scientific Evidence Shows that School-Based Sealant
Findings from scientific studies clearly show that school dental sealant
programs work to stop tooth decay.
The Task Force on Community Preventive Services recommends school sealant
programs and issued a
strong endorsement* in 2001. In 2003, the Association of State and
Territorial Dental Directors published a
Practice Approach Report.* This report reviews the scientific evidence that
school sealant programs work and presents specific examples of practices in
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CDC-Sponsored Expert Work Group Publishes Updated Recommendations for School-Based Sealant Programs
Dental Caries Through School-Based Sealant Programs: Updated Recommendations
and Review of Evidence,”* Journal of the American Dental
Association, November 2009, provides guidance to school-based sealant
The recommendations were developed by a work
group of experts in the fields of caries prevention and treatment, oral
epidemiology, and evidence-based reviews. The work group also included
representatives from professional dental organizations.
The expert work group examined new evidence on:
- The effectiveness of sealants in preventing new decay and progression of
- Methods to assess decay
- Sealant placement techniques
- Scientific reviews of program practices
Based on this evidence, the following recommendations are provided for
practitioners in school-based programs:
- Seal pit-and-fissure tooth surfaces that are sound or have early decay,
prioritizing first and second permanent molars.
- Use visual assessment to differentiate surfaces with the earliest signs
of tooth decay from more advanced lesions.
- X-rays are not needed solely for sealant placement.
- A toothbrush can be used to help clean the tooth surface before acid
- When resources allow, have an assistant help the dental professional
- Provide sealants to children even if follow-up examinations for every
child cannot be guaranteed.
These recommendations are designed to guide practices of state and community
public health programs for planning, implementing, and evaluating
school-based sealant programs, as well as to complement the American Dental
Association Council on Scientific Affairs’
evidence-based clinical recommendations for sealant use*
published in 2008.
Several other publications provide more detail about the studies that were
conducted by work group members. The published studies are provided below.
Effectiveness of Sealants in Managing Caries Lesions,”* Journal of
Dental Research. February 2008. This study shows that if sealants are
placed over early tooth decay, they will stop early decay from becoming a
cavity. This information should lessen concerns about accidentally sealing
- “The Effect of
Dental Sealants on Bacteria Levels in Caries Lesions: A Review of the
Evidence,”* Journal of the American Dental Association. March
2008. This study shows that sealing over tooth decay lowers the number of
bacteria in the cavity by at least 100-fold.
Four-Handed Delivery and Retention of Resin-Based Sealants,”* Journal
of the American Dental Association. March 2008. For sealants to work,
they must stay in place or be retained on the tooth. This study concludes
that having a dental assistant help the dental professional place the
sealant (four-handed technique) may improve sealant retention.
- "A Comparison of
the Effects of Toothbrushing and Handpiece Prophylaxis on Retention of
Sealants,"* Journal of the American Dental Association. January
2009. This study shows that cleaning the tooth's surface with a toothbrush
before applying dental sealants resulted in sealant retention at least as
high as when a hand piece was used.
- "Caries Risk in
Formerly Sealed Teeth,"* Journal of the American Dental Association.
April 2009. This study shows that teeth with fully or partially lost
sealants did not have a higher risk of developing a cavity than teeth that
were never sealed.
- Techniques for Assessing Tooth Surfaces in School-Based Sealant
Programs.” Journal of the American Dental Association. July 2010.
This article presents a review of the evidence supporting current guidelines
for the detection of cavitated carious lesions in school-based sealant
programs. The authors conclude that visual examination is appropriate for
caries assessment before placing sealants; clinicians should not use an
explorer under force; and radiographs are not indicated solely for the
placement of sealants; and the use of magnification and caries detection
devices is not necessary to determine cavitation.
- Oral Health
in America: A Report of the Surgeon General. This U.S. Surgeon General's
report was the first to focus on oral health provides an overview on
effectiveness of sealants and public health strategies to provide sealants
to children in community settings.
- Seal America: The
Prevention Invention* is an online manual designed to assist health
professionals initiate and implement a school-based dental sealant program.
- School-Based Dental Sealant Programs in Ohio. A five-part,
distance-learning course provided to further understanding of the history,
operations, and underlying principles of Ohio’s school-based dental sealant
programs. Available at:
- CDC Expert Workgroup on School-Based Dental
Sealant Programs. Members of the CDC-sponsored expert workgroup.
One or more documents on this Web page is available in Portable Document Format
(PDF). You will need Acrobat
Reader to view and print these documents.
* Links to non-Federal organizations are
provided solely as a service to our users. Links do not constitute an
endorsement of any organization by CDC or the Federal Government, and none
should be inferred. The CDC is not responsible for the content of the individual
organization Web pages found at this link.