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 early decay
- 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 etching.
- When resources allow, have an assistant help the dental professional place sealants.
- 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* (PDF–245K) published in 2008.
Preventing 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 programs.