Dental Sealants for Caries Prevention

Complete report

Dental sealants applied in childhood can help prevent caries, but knowledge of the availability of sealants and their function is not widespread. We assessed knowledge of dental sealants among US adults and adult parents of children younger than 18 and the differences in knowledge among demographic and socioeconomic groups.
Methods
We used data on 3,550 respondents to the 2015 FallStyles B survey of noninstitutionalized US adults aged 18 or older. Authors constructed estimates by using weights provided to reflect the distribution of the US population. Knowledge of dental sealants was assessed by sex, age, race/ethnicity, education, household income, and parental status. Multivariate analysis was conducted by using a main effects logistic regression model.
Results
Overall, 46.3% of adults and 55.1% of parents of children younger than 18 had knowledge of dental sealants. Sealant knowledge was highest among parents, women, respondents aged 45 to 59, and respondents with incomes greater than 200% of the federal poverty level and more than a high school education. Non-Hispanic blacks had less than half the odds of non-Hispanic whites of having knowledge of sealants (adjusted odds ratio [OR] = 0.4), and nonparents had half the odds as parents (OR = 0.5) of knowing. The strongest predictors of parental sealant knowledge were race/ethnicity, sex, and income.
Conclusion
Disparities in sealant knowledge correspond to disparities in sealant prevalence. Increasing knowledge among low-income and racial/ethnic minority parents could reduce disparities in sealant prevalence and untreated caries.

Although largely preventable, dental caries is one of the most common chronic diseases among children and adolescents (1). National data from 2011 through 2014 show that approximately 18% of children aged 6 to 11 and 58% of children aged 12 to 19 in the United States had treated or untreated caries in their permanent teeth (2). Disparities in caries prevalence exist across races and ethnicities and family income levels, and prevalence is highest among minority and socio-economically disadvantaged populations (2). If left untreated, dental caries can cause pain, speech problems, and missed time from school (1).
About 90% of caries in permanent teeth occur in the posterior teeth (3). Dental sealants are widely recommended by professional health organizations (4,5) because they prevent about 90% of posterior caries one year after placement and about 50% 5 years after placement (6). Prevalence of sealant use in children aged 6 to 11 rose 12.4 percentage points from 1999–2004 to 2011–2014, from 31.1% to 43.6% (7). Children from low-income households (<185 20="" a="" about="" are="" children="" federal="" from="" higher="" households="" however="" income="" less="" level="" likely="" of="" p="" poverty="" receive="" sealant="" than="" the="" to=""> Recent attention to health literacy highlights the complex relationship between knowledge and actions that support health (8). A recent analysis of sealant prevalence in children found that among high income parents (≥100% of the federal poverty level), sealant prevalence increased with parental education (a proxy for health literacy) (9). Because oral health literacy is required to make informed health decisions and can affect receipt of services, determining public knowledge of the purpose of sealants is important. No national data characterize knowledge of sealants among all US adults and among parents of children younger than 18. We assessed knowledge of the purpose of sealants and the differences in knowledge among demographic and socioeconomic groups. Information from our study provides a baseline for future studies of sealant knowledge and can be used to identify need for promoting oral health education and increasing oral health literacy.