Sealants and Fluoride Varnish
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.
Recommendations for school-based sealant programs
Equipment
Selecting supplies and equipment, step 4 (Seal America)
- ADA Clinical Guidelines Chairside Guide
- Dental technique for glass ionomer dental sealant video
- Dentla technique for resin-based dental sealant video
Dental Sealant Trainings and Resources:
- National Maternal and Child Oral Health Resource Center School-based dental sealant training program that offers modules and a pre/post test to complete: https://www.mchoralhealth.org/dental-sealant/
- Seal America a step-by-step best practices guide to starting a school sealant program: https://www.mchoralhealth.org/seal/index.php
- ASTDD Best Practices Approach: School-Based Dental Sealant Programs: https://www.astdd.org/bestpractices/school-based-dental-sealant-programs-bpar-2022-final.pdf
- Infection Prevention & Control Guide for School Sealant Programs by Organization for Safely, Asepsis and Prevention (OSAP): https://osap.memberclicks.net/assets/docs/resources/portable-mobile/ipc-guide-for-school-sealant-programs-2022.pdf
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.