Assessment of retention rates and clinical benefits of a community sealant program

Purpose: The purposes of this study were to: (1) evaluate the retention rates of occlusal sealants in children in an urban school-based sealant program run by a County Health Department in Alabama; and (2) assess the clinical benefits of this sealant program by comparing caries experience of a group of participants and nonparticipants. Methods: The records of 2,097 children (mean age=8.1±1.6 years) who received sealants and had at least 1 follow-up examination were analyzed to determine the outcome of sealed and nonsealed surfaces of permanent first molars (PFM). Additionally, 103 fifth-grade students who did and did not participate in the sealant program (P=participants; NP=nonparticipants) were examined by a masked examiner who recorded their PFM condition. Results: Sealants placed by the County Health Department had a retention rate of 71% over an average of 1.6±0.7 years (range=0.5-4.4 years). The patient's age at the initial visit appeared to be the only factor that influenced retention. On average, participants had at least 1 PFM that remained caries-free, compared to nonparticipants (permanent decayed, missing, and filled teeth [DMFT] in NP=1.5±1.4, P=0.5±0.8; P<.016). Conclusions: Retention rates for occlusal sealants in this public health program were similar to those reported in previous clinical studies. Furthermore, children who had sealants had significant protection from occlusal decay up to grade 5.