Dental Caries (Cavities): Community-Based Initiatives to Promote the Use of Dental Sealants
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) finds insufficient evidence to determine the effectiveness of community-based initiatives to promote use of dental sealants. Although strong evidence exists for the efficacy of sealants and their delivery through school-based programs for preventing caries (tooth decay), few studies examined uptake of sealants following community-based promotion initiatives and their results were inconsistent.
The full CPSTF Finding and Rationale Statement and supporting documents for Oral Health: Preventing Dental Caries, Community-Based Initiatives to Promote the Use of Dental Sealants are available in The Community Guide Collection on CDC Stacks.
Intervention
Community-based dental sealant promotion initiatives aim to increase sealant use, especially among specific populations at high risk for tooth decay (e.g. low-income). These initiatives can take many forms including continuing education courses for dental professionals; educational campaigns for parents, community leaders, or third party payers of dental treatment; policies to promote access to sealants; financial incentives or reimbursement; and promotional activities to increase the number of schools with sealant delivery programs and the number of students participating in these programs.
School-based sealant delivery programs, which are distinct from community-based initiatives to promote use of sealants, have been recommended by CPSTF based on strong evidence of effectiveness in preventing tooth decay among children.
About The Systematic Review
The CPSTF finding is based on evidence from a systematic review of three studies (search period 1946-2012). The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to oral health.
Study Characteristics
- Included evidence comes from the United States (2 studies) and the United Kingdom (1 study).
- Studies reported the percentage of children who received sealants, the number of sealants applied per child, and the extent of sealant use among dentists.
Summary of Results
Included studies evaluated interventions that used education, mass media, financial incentives, or a combination of these methods.
- One intervention offered financial incentives to dental health professionals and saw a significant 9.8 percentage point increase in the number of children who received sealants.
- Neither education (2 study arms) nor mass media (1 study) showed significant effects on sealant use.
Summary of Economic Evidence
An economic review of this intervention was not conducted because CPSTF did not have enough information to determine if the intervention works.
Applicability
Applicability of this intervention across different settings and populations was not assessed because CPSTF did not have enough information to determine if the intervention works.
Evidence Gaps
- More evidence is needed to assess the effectiveness of community-based sealant promotion initiatives for increasing sealant use.
- Additionally, research should be done to better understand dental health professionals’ beliefs and other barriers that prevent change with regard to sealant application.
Implementation Considerations and Resources
- CPSTF did not have enough evidence to determine whether the intervention is or is not effective. This does not mean that the intervention does not work, but rather that additional research is needed to determine whether or not the intervention is effective
- Other evidence-based interventions such as school-based sealant delivery programs should be considered when making decisions about potential ways to increase sealant use