School Sealant Programs

What to know

Dental sealants protect against cavities for many years. Dental sealants are thin coatings applied to chewing surfaces of back teeth. School sealant programs can make a big difference in improving children's oral health. They are an effective way to provide dental sealants to millions of children to prevent cavities.

School-aged children lean against a fence and smile together.

About school sealant programs

School sealant programs provide pit and fissure dental sealants to children using portable equipment in a school setting. Learn more about dental sealants here.

Each state-coordinated program may be different in their structure. School sealant programs usually focus on providing sealants to children aged 6 to 11 years (or in grades 1 through 5). A typical sealant program will visit an individual school over the course of 1 to 3 days. During their visit:

  • A licensed dental professional will screen children for oral disease. They also check to see if the children already have sealants, and if so, how well those sealants are being retained.
  • Children with a signed permission slip from their parent or guardians who do not have dental sealants will get them applied, typically at no cost.
  • Any child that needs additional follow-up care will get a referral to a local dentist.

Why it's important

School sealant programs are especially important for reaching children who are at greater risk for developing cavities and less likely to receive private dental care. Compared with children from higher income families, children from low-income families are more likely to:

  • Have untreated cavities.1
  • Have few or no dental sealants.1
  • Not have had yearly dental visits.2

Programs generally work with schools with a higher percentage of children eligible for federal free or reduced-cost meal programs.

Evidence of impact

The Community Preventive Services Task Force strongly recommends school-based sealant delivery programs to prevent cavities among children.3 CDC funds the coordination of school sealant programs.

The programs are also cost-effective. School sealant programs can be cost-saving within 2 years of placing sealants. Delivering sealants to children at high risk for cavities can be cost saving to Medicaid.4 By applying sealants to the nearly 7 million children in households with lower incomes who do not have sealants, we could prevent more than 3 million cavities and save up to $300 million in dental treatment costs.56

Implementation considerations

School sealant programs can be supported by other efforts to increase the use of dental sealants.

The federal government promotes sealant use by:

  • Classifying pediatric dental services as an essential health benefit to be covered by dental insurance as part of the Affordable Care Act.
  • Matching state costs for applying dental sealants for all children enrolled in Medicaid and the Children's Health Insurance Program (CHIP), and tracking program performance.
  • Encouraging community health centers with dental programs to start or expand school sealant programs to help more children from low-income families.
  • Helping fund states to increase the number of dental sealant programs.
  • Providing incentives for dentists to practice in underserved areas to increase access to dental service.

State officials can help by:

  • Sending school sealant programs to the areas of greatest need.
  • Tracking the number of schools and children participating in sealant programs.
  • Implementing policies that deliver school sealant programs in the most cost-effective manner.
  • Helping schools connect to Medicaid and CHIP, local health department clinics, community health centers, and dental providers in the community to encourage more use of sealants and reimbursement of services.
  1. Griffin SO, Wei L, Gooch B, Weno K, Espinoza L. Changes in dental sealant and untreated tooth decay prevalence and the estimated impact of increasing school-based sealant program coverage. MMWR Morb Mortal Wkly Rep. 2016;65:1141-1145.
  2. Griffin SO, Barker LK, Wei L, Chien-Hsun L, Albuquerque MS, Gooch BF. Use of dental care and effective preventive services in preventing tooth decay among US children and adolescents—Medical Expenditure Panel Survey, United States, 2003–2009 and National Health and Nutrition Examination Survey, United States, 2005–2010. MMWR Morb Mortal Wkly Rep. 2014;63(2):55–61.
  3. Community Preventive Services Task Force. Dental Caries (Cavities): School-Based Dental Sealant Delivery Programs. The Community Guide. Accessed February 21, 2024.
  4. Griffin SO, Naavaal S, Scherrer CR, Patel M, Chattopadhyay S. Evaluation of school-based dental sealant programs: an updated Community Guide systematic economic review. Am J Prev Med. 2017;52(3):407-415.
  5. Griffin SO, Wei L, Gooch BF, Weno K, Espinoza L. Vital Signs: Dental Sealant Use and Untreated Tooth Decay Among U.S. School-Aged Children. MMWR Morb Mortal Wkly Rep. 2016;65:1141-1145.
  6. Centers for Disease Control and Prevention. Dental Sealants Prevent Cavities: Effective protection for children. US Dept of Health and Human Services; 2016. Accessed February 21, 2024.