School Sealant Programs

Line of smiling children

School sealant programs are an effective way to reach millions of children with dental sealants to prevent cavities. The Community Preventive Services Task Force strongly recommends using school-based sealant delivery programs to prevent cavities among children.1 In addition, school sealant programs can be cost-saving within 2 years of placing sealants, and delivering sealants to children at high risk for cavities can be cost-saving to Medicaid.2

CDC supports states to put into action school sealant programs that reduce oral disease and improve oral health. As part of CDC’s State Actions to Improve Oral Health Outcomes (DP-1810), CDC funds 20 states and one territory for implementing evidence-based preventive interventions to include expanding sealant delivery in low-income and rural schools.


School sealant programs provide pit and fissure sealants to children using portable equipment in a school setting. Although each state-coordinated program may be different in how they structure their program, generally speaking, school sealant programs 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. 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 parents 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.

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

Compared with children from higher income families, children from low-income families are more likely to:

  • Have untreated tooth decay.3
  • Have few or no dental sealants.3
  • Not have had yearly dental visits.4

Ways to Increase Sealant Use

There are many actions that states, dental providers, schools, and parents can take to increase sealant prevalence.

The federal government is promoting 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/CHIP and tracking program performance
  • Encouraging community health centers with dental programs to start or expand school-based sealant programs to help more low-income children
  • 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

  • Targeting school-based sealant programs to the areas of greatest need
  • Tracking the number of schools and children participating in sealant programs
  • Implementing policies that deliver school-based sealant programs in the most cost-effective manner
  • Helping schools connect to Medicaid and the Children’s Health Insurance Program (CHIP), local health department clinics, community health centers, and dental providers in the community to encourage more use of sealants and reimbursement of services

Dental care providers can help by

  • Applying sealants to children at highest risk of cavities, including those covered by Medicaid/CHIP
  • Donating time and resources to a school-based dental sealant program
  • Learning about school-based dental sealant programs and their effectiveness
  • Accepting children into their practice who are identified as needing more services when they receive sealants in schools

School administrators can help by

  • Working with the local or state public health programs and local dental providers to start school-based sealant programs
  • Supporting sealant programs in schools and promoting its benefits to teachers, staff, and parents
  • Encouraging schools to develop relationships with local dental offices and community dental clinics to help children get dental care
  • Helping children enroll in sealant programs by putting information for parents in registration packets in the beginning of the school year

Parents can help by

  • Ask your child’s dentist to apply sealants when appropriate.
  • Sign your child up to participate in a school-based sealant program. If your school does not have sealant program, ask them to start one.
  • Find a dentist if your child needs one. Use the Insure Kids Now Dentist Locator to find a dentist that takes Medicaid and CHIP.