1.2 Rationale and Evidence for Programs

Evidence-Based Decision-Making

Programs Evidence Base

In 2001, a systematic review conducted by the Task Force on Community Preventive Services found that school-based and school-linked dental sealant programs are effective in reducing dental caries. The task force concluded that15

• School-based dental sealant programs should be included as part of a comprehensive population-based strategy to prevent or control dental caries in communities.
• Dental sealants are best applied to children from high-risk populations by trained auxiliaries.
• Exposure to school-based dental sealant programs was associated with a median relative decrease in dental caries experience of 65 percent.

Dental Sealant Cost-Effectiveness

Several studies have researched dental sealant cost-effectiveness either by looking at program data or by developing cost-effectiveness models based on hypothetical populations. A number of variables (e.g., retention rate, length of study, caries risk of population) influence the extent to which sealants save money.

A study of children enrolled in Medicaid in North Carolina (1985–1992 data) estimated that unsealed first permanent molars were almost three times more likely (22 percent vs. 8 percent) than sealed molars to receive a caries-related service involving the occlusal surface.16

Studies that modeled the cost-effectiveness of dental sealants applying population-based parameters to hypothetical populations have consistently found sealants to be cost-saving when delivered to populations at higher risk for dental caries.13, 17, 18

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