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Dental Sealants: An Important Tool in Fight Against Cavities

With the right tools, cavities (caries) are almost entirely preventable. Yet caries remains the single most common chronic childhood disease–five times more common than asthma. As one tool in the fight against caries, dental sealants are both cost and health effective. We encourage their use in young enrollees, and sealant benefits are standard coverage for children in all our programs.

Dental sealants protect teeth by forming a barrier against the harmful bacteria that can cause tooth decay. Applied by a dentist or dental staff, sealants fill the grooves and pits of teeth, usually without drilling. With this barrier in place, the acids that are produced as a by–product of specific kinds of bacteria in the mouth have a hard time getting to the teeth. Without such a barrier in place, these acids can dissolve minerals in teeth, a process called demineralization that can ultimately lead to cavities. Sealants have been shown to reduce the need for fillings by 72 percent.

“Applying dental sealants to children's caries–free permanent molars significantly reduces the risk of cavities.”

Biting surfaces of molar teeth are the most likely locations for this to happen (88.8 percent of children's cavities occur here) because harmful bacteria that produce acid can hide in the grooves and pits on molar surfaces. Using reviewed literature, we know that children who have received a single molar filling have greater than a 90 percent chance of receiving fillings on all their other molars within the next five years.

To protect children from tooth decay, we encourage the use of sealants on caries–free permanent molars for children who have had cavities in other primary or permanent molars. Sealants generally stop the need for the first filling in these caries–free teeth, which is important because science has not yet developed permanent filling materials. Avoiding the first filling stops the need for subsequent filling replacements, thus lowering the lifetime cost of dental care and improving the patient's quality of life.

Applying dental sealants to children's caries–free permanent molars significantly reduces the risk of cavities and is one way of improving health and lowering costs. The National Center for Chronic Disease Prevention and Health Promotion says “Sealants should be used as part of a child's total preventive dental care. A complete preventive dental program includes use of sealants, fluoride, plaque removal, careful food choices, and regular dental care.”

We are currently analyzing our data to determine whether it is also cost and health efficient to cover sealants in adults. If our data show a benefit, we will provide recommendations for new sealant benefits.

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