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School-based Dental Sealant Program

The Minnesota Department of Health (MDH) School-based Dental Sealant Program (SDSP) is part of a comprehensive state-wide Oral Health Program to promote evidenced-based prevention strategies in order to achieve optimal oral health for all Minnesotans. Funding for Minnesota’s Oral Health Program is provided by grants from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA).



Target Priorities

School-based dental sealant programs target 6-8 year olds. After losing their state funding, one oral health program was asked by a local health department:“Can we also apply sealants on molars of other age groups (those children who lost their sealants and/or never received sealants)? Would there be any benefit from doing that?”

Click on this blue collapsible bar for a thoughtful reply from Peg Snow of the Department of Health and Human Services in New Hampshire:
  • Placing sealants on children older than 7 and replacing "lost" sealants does no harm, and may provide some protective benefit. The reason to target 6-8 year olds for sealants has to do with resource allocation based on highest risk.
    The greatest risk for occlusal decay is in the first 18 months following eruption, with risk declining afterwards, all things being equal. Thus, dedicating efforts to 6-8 year olds will produce the best cost benefit (cost efficiency) ratio. Teeth that have not yet decayed by age 8 are likely in kids with lower risk of decay, so applying sealants will produce a less robust cost efficiency. This does not address the situation if the 8 year olds have incipient occlusal decay. These kids can't be included in the group of unsealed-without-decay, as they are on the path to decay and sealants would be highly beneficial.

    Likewise, some studies have indicated that even sealants that appear to have been lost (hence the quotation marks) are actually retained within the fissures and are affording protection. So the benefit of replacing sealants is less than that of sealing newly erupted, never before sealed teeth.

    So the question you ask is more an economic question of resource allocation than a clinical question. If funding is tight and allocations must be made, it's likely that the priority ranking that will produce most efficiency would be: targeting 6-8 year olds first, then never-before sealed first molars in kids closer to 6-8, then never sealed older kids, then finally resealing kids with lost sealants.


The Minnesota Department of Health Oral Health Program concurs with this response because it reflects current evidence-based knowledge of the science behind dental sealants when used in public health settings.

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Resources

American Academy of Pediatrics
http://www.aap.org/oralhealth/

ASTDD-OSAP Infection Prevention and Safety Project
http://www.osap.org/?page=DentPH_IpAndSafety#inthenews

Task Force on Community Preventive Resources:
http://www.thecommunityguide.org/about/task-force-members.html

MI Paste Video:
http://www.youtube.com/watch?v=rvmmMEyPcSg


Sealant FAQs

Click blue collapsible bar for answer.
What are dental sealants?
Sealants are clear or white in color and cover the grooved and pitted surfaces of the teeth, especially the chewing surfaces of the back teeth where most cavities in children are found. Sealants are put on permanent teeth to help keep them cavity free.
How do sealants work?
Even if your child brushes and flosses carefully, it is very hard – sometimes impossible – to clean the tiny grooves and pits on back teeth. Food and germs hide in these spots to cause tooth decay. Sealants “seal out” food and germs and will help protect your child’s teeth.
How long do sealants last?
Research shows that sealants can last for many years. Your child’s teeth will be protected through the most decay prone years. The sealants will last longer if your child takes good care of their teeth and avoids biting hard objects. At your child’s regular dental check-up, the sealants will be checked and more sealant may be applied if missing
How are sealants put on the teeth?
Sealants are quick and easy. First the tooth is cleaned and a special liquid is placed on the tooth to get it ready. Next, the special liquid is dried allowing the sealants to flow into the grooves of the tooth. Lastly, it is hardened with a special light. Once the sealant is placed, your child may eat right away.
Which teeth should be sealed?
The teeth most likely to get decay are the ones with grooves and fissures so the most important teeth to seal are the first and second permanent molars.
If my child has sealants, are brushing and flossing still important?
Yes! Sealants are only one part of the plan to keep your child from getting cavities. Brushing, flossing, eating healthy foods with limited snacking and regular check ups at your dentist will give your child a healthy smile.
Will sealants replace fluoride?
No. Fluorides such as those used in fluoridated water, fluoride toothpaste, and fluoride mouthrinses help prevent decay on the smooth sides of the teeth. However, fluorides help the teeth less on the rough, pitted chewing surfaces of the back teeth where food particles and decay-producing bacteria are trapped. Sealants are more effective on these areas than fluoride.
Have sealants been tested to be safe and proven to work?
Yes. Tens of thousands of children across the United States and in other countries have had their teeth successfully sealed. Studies show sealants to be safe, effective, easy to apply and less costly compared to fillings. School-based dental sealant programs have been approved by the American Dental Association, the Center for Disease Control and the U.S. Surgeon General.
How are dental sealants different than fluoride varnish?
Fluoride varnish and dental sealants are different substances that both protect children's teeth from decay. Fluoride varnish protects your child's first teeth, called primary teeth. It is applied twice per year from age one to age six or seven when a child gets permanent teeth. Fluoride varnish works by repairing (remineralizing) gaps in the tooth enamel, protecting teeth from plaque.
Once children have their permanent teeth, dental sealants provide the protection for the back teeth, or molars. Dental sealants cover the deep grooves in permanent molars so that decay is much less likely to start. Sealants are applied when children get their first molars between five to seven years of age and when they get their second set of permanent molars around the age of eleven to fourteen.

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Referral Center

The Minnesota Department of Human Services (DHS) is a great resource. DHS has established a call center where you can get information about programs and eligibility. The DHS call center can be reached at: 651-431-2670 or 800-657-3739.

United Way 2-1-1 and Portico Healthnet are partnering to offer 24/7 information and referral assistance to individuals and families who may be eligible for Medical Assistance. The eligibility rules for Medical Assistance coverage changed on March 1, 2011, and more people are now able to qualify. For more information, call United Way 2-1-1 at 1-800-543-7709 (statewide, 24 hours a day, 7 days a week). Callers needing further assistance will be transferred to Portico Healthnet. Portico staff will:

  • Answer your questions about Medical Assistance & MinnesotaCare
  • Help you understand your options for health care
  • Assist you with applications for health coverage programs
  • Give you information about low-cost clinics and other health care resources in your area

Individuals who do not qualify for Minnesota Health Care Programs (MHCP) can get information about low-cost clinics and prescription assistance.

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For More Information

Contact us at health.oral@state.mn.us

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Updated Thursday, April 25, 2013 at 11:50AM