States That Seal the Deal on Dental Implants

Tooth decay is the most common preventable childhood disease, with 21% of children ages 6 to 11 and 58% of adolescents ages 12 to 19 having caries in their permanent teeth.¹ Greater use of dental sealants could reduce those numbers significantly. In the August issue of the Journal of the American Dental Association, a panel convened by the American Dental Association Council on Scientific Affairs and the American Academy of Pediatric Dentistry published the most systematic review of studies on the subject to date.

The panel found that within two to three years of application of dental sealants, the children who received them had reduced their risk of new carious lesions by 76%. Within four to seven years, the risk was 79% lower. And after seven years, it was 85% lower.²

As a result of the review, clinical guidelines have been updated to strongly recommend sealants for children and adolescents, particularly for the prevention of caries in the pits and fissures of teeth where other preventive therapies like fluoride treatment and brushing are less effective.³ However, despite this strong evidence, fewer than half of U.S. children and teens receive dental sealants. The rate is lowest for non-Hispanic black children and teens, who also have the highest rates of caries.¹

School-based programs have been proven effective at getting sealants on kids’ teeth — particularly in underserved populations where cost, lack of transportation and lack of parent knowledge have been barriers. Yet not all statelevel programs are created equal. A 2015 report by The Pew Charitable Trusts awarded grades to states’ school-based dental sealant programs based on four criteria:

1. The extent to which sealant programs are serving highneed schools, typically de – fined as having at least 50% of students in the National School Lunch Program.
2. Whether dental hygienists are allowed to place sealants without a dentist’s exam.
3. Whether states collect data for a national database.
4. The overall proportion of students receiving sealants.

Only five states earned an A or A-, while three states and the District of Columbia received an F.⁴ With new practice guidelines clearly indicating dental sealants are effective, the next challenge may be addressing health disparities and advocating at the state policy level to ensure all children who need sealants can receive them.

References

1. Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and sealant prevalence in children and adolescents in the United States, 2011–2012. NCHS data brief, no. 191. Hyattsville, MD: National Center for Health Statistics. 2015.
2. Wright JT, Tampi MP, Graham L, et al. Sealants for preventing and arresting pit-and-fissure occlusal caries in primary and permanent molars. J Am Dent Assoc. 2016;147;631–645.
3. Wright JT, Crall JJ, Fontana M, et al. Evidence-based clinical practice guideline for the use of pit-and-fissure sealants. J Am Dent Assoc. 2016;147;672–682.
4. Pew Charitable Trusts. States Stalled on Dental Sealant Programs. Available at: http://www.pewtrusts.org/~/media/assets/2015/04/dental_sealantreport_final.pdf. Accessed August 17, 2016.

From Decisions in Dentistry. September 2016;2(09):60.