Preventing dental caries through School-based sealant programs: Updated recommendations and reviews of evidence

Barbara F. Gooch, Susan O. Griffin, Shellie Kolavic Gray, William G. Kohn, R. Gary Rozier, Mark Siegal, Margherita Fontana, Diane Brunson, Nancy Carter, David K. Curtis, Kevin J. Donly, Harold Haering, Lawrence F. Hill, H. Pitts Hinson, Jayanth Kumar, Lewis Lampiris, Mark Mallatt, Daniel M. Meyer, Wanda R. Miller, Susan M. Sanzi-SchaedelRichard Simonsen, Benedict I. Truman, Domenick T. Zero

Research output: Contribution to journalArticlepeer-review

113 Scopus citations


Background. School-based sealant programs (SBSPs) increase sealant use and reduce caries. Programs target schools that serve children from low-income families and focus on sealing newly erupted permanent molars. In 2004 and 2005, the Centers for Disease Control and Prevention (CDC), Atlanta, sponsored meetings of an expert work group to update recommendations for sealant use in SBSPs on the basis of available evidence regarding the effectiveness of sealants on sound and carious pit and fissure surfaces, caries assessment and selected sealant placement techniques, and the risk of caries' developing in sealed teeth among children who might be lost to follow-up. The work group also identified topics for which additional evidence review was needed. Types of Studies Reviewed. The work group used systematic reviews when available. Since 2005, staff members at CDC and subjectmatter experts conducted several independent analyses of topics for which no reviews existed. These reviews include a systematic review of the effectiveness of sealants in managing caries. Results. The evidence supports recommendations to seal sound surfaces and noncavitated lesions, to use visual assessment to detect surface cavitation, to use a toothbrush or handpiece prophylaxis to clean tooth surfaces, and to provide sealants to children even if follow-up cannot be ensured. Clinical Implications. These recommendations are consistent with the current state of the science and provide appropriate guidance for sealant use in SBSPs. This report also may increase practitioners' awareness of the SBSP as an important and effective public health approach that complements clinical care.

Original languageEnglish (US)
Pages (from-to)1356-1365
Number of pages10
JournalJournal of the American Dental Association
Issue number11
StatePublished - Nov 2009
Externally publishedYes


  • Caries
  • Evidence-based dentistry
  • Pit-and-fissure sealants
  • Preventive dentistry
  • Public health/community dentistry

ASJC Scopus subject areas

  • Dentistry(all)


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