School-Based Dental Programs

Sealants and Fluoride Varnish

School-based programs are an effective way to bring preventive oral health services to children. The two most common school-based programs are dental sealants and fluoride varnish. Both these school programs help to reach children who may not have access to regular dental care and prevent dental caries (tooth decay) to help keep children healthy and in school. To participate in school dental sealant and fluoride programs, dental professionals partner with the schools to gain permission to be onsite and obtain consent from the parents/caregivers.
 

What are the components of a school-based dental program?

1.    Screen

2.    Provide Preventive Services

3.    Connection to Care

4.    Quality Assurance

 

Dental Sealants

What are dental sealants?

Dental sealants are a thin coating applied to the chewing surfaces of the back teeth (molars). They are quick to apply, taking 2-3 minutes depending on the technique, and can last for years to prevent up to 80% of cavities for 2 years and continue to protect against 50% of cavities for up to 4 years.

When to place dental sealants?

The best times to apply sealants are when the child’s 1st and 2nd permanent molars start to erupt around ages 6 and 12. In dentistry, the first and second molars are called the 6-year and 12-year molars. Sealants are most effective when applied soon after the permanent molars erupt to seal off the deep grooves on the chewing surfaces of the molars and provide more fluoride to the newly erupted tooth. Given oral hygiene is challenging at these ages, dental sealants can provide extra protection.

2nd and 3rd grade is the best time to apply dental sealants, due to newly erupted molars.

Where can dental sealants be applied?

School-based programs can provide dental sealants to students at schools using portable dental equipment. Usually, school dental programs target schools in low-income neighborhoods known to have free-reduced lunch programs and to populations with a high risk for dental caries (tooth decay).

Who can apply dental sealants?

California licensed dental professionals can apply dental sealants without supervision in a public health setting, including Registered Dental Hygienists (RDH) and Registered Dental Hygienist in Alternative Practice (RDHAP) (BPC 1911). Registered Dental Assistants (RDA) and Registered Dental Assistants in Extended Function (RDAEF) can apply dental sealants with the direct supervision of a dentist.

  • Add SOP table from SB/SL manual for sealants

How do dental professional apply dental sealants and clinical guidelines?

Sealants are applied to healthy teeth to create a shield on the chewing surfaces of the tooth to prevent bacteria from causing tooth decay. A visual assessment is supported by the ADA and CDC as best practices to determine the placement of sealants.

Equipment

Selecting supplies and equipment, step 4 (Seal America)

Dental Sealant Trainings and Resources:

Publications:

  • Community Preventive Services Taskforce Oral Health: Preventing Dental Caries, School-Based Dental Sealant Delivery Programs: https://www.thecommunityguide.org/media/pdf/Oral-Health-Caries-School-based-Sealants_0.pdf
  • Oral Health Status of Children: Results of the 2018–2019 California Third Grade Smile Survey: https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CDCB/CDPH%20Document%20Library/Oral%20Health%20Program/California_2019_3rd_Grade_Smile_Survey_20210730.pdf
  • Preventing dental caries through school-based sealant programs Updated recommendations and reviews of evidence: https://jada.ada.org/article/S0002-8177(14)64584-0/fulltext
  • Evidence-based clinical practice guideline for the use of pit-and-fissure sealants A report of the American Dental Association and the American Academy of Pediatric Dentistry: https://jada.ada.org/action/showPdf?pii=S0002-8177%2816%2930473-1
  • AAP Evidence-based Clinical Practice Guideline for the Use of Pit-and-Fissure Sealants: https://www.aapd.org/assets/1/7/G_EBD-Sealants1.PDF
  • Economic Evaluations of School Sealant Programs and the Consent Conundrum: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900435/
    • Citation: Huang SS, Niederman R. Economic Evaluations of School Sealant Programs and the Consent Conundrum. J Dent Res. 2019 Feb;98(2):145-147. doi: 10.1177/0022034518806838. Epub 2018 Oct 24. PMID: 30354919; PMCID: PMC6900435.
  • Community Preventive Services Taskforce Oral Health: Preventing Dental Caries, School-Based Dental Sealant Delivery Programs: https://www.thecommunityguide.org/media/pdf/Oral-Health-Caries-School-based-Sealants_0.pdf
  • Oral Health Status of Children: Results of the 2018–2019 California Third Grade Smile Survey: https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CDCB/CDPH%20Document%20Library/Oral%20Health%20Program/California_2019_3rd_Grade_Smile_Survey_20210730.pdf
  • Preventing dental caries through school-based sealant programs Updated recommendations and reviews of evidence: https://jada.ada.org/article/S0002-8177(14)64584-0/fulltext
  • Evidence-based clinical practice guideline for the use of pit-and-fissure sealants A report of the American Dental Association and the American Academy of Pediatric Dentistry: https://jada.ada.org/action/showPdf?pii=S0002-8177%2816%2930473-1
  • AAP Evidence-based Clinical Practice Guideline for the Use of Pit-and-Fissure Sealants: https://www.aapd.org/assets/1/7/G_EBD-Sealants1.PDF
  • Economic Evaluations of School Sealant Programs and the Consent Conundrum: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900435/
    • Citation: Huang SS, Niederman R. Economic Evaluations of School Sealant Programs and the Consent Conundrum. J Dent Res. 2019 Feb;98(2):145-147. doi: 10.1177/0022034518806838. Epub 2018 Oct 24. PMID: 30354919; PMCID: PMC6900435.