Do school-based dental sealant programs reach higher risk children?

Area of Science:

• Public Health
• Pediatric Dentistry
• Health Services Research

Background:

• Dental caries remains a significant public health issue, particularly among children.
• Access to preventive dental services like sealants can be inequitable, disproportionately affecting higher-risk populations.
• School-based dental sealant programs (S-BSPs) are a key strategy to improve oral health equity.

Purpose of the Study:

• To compare dental sealant prevalence by caries risk in Ohio third graders attending schools with and without S-BSPs.
• To estimate the proportion of children receiving sealants through S-BSPs who are classified as higher risk for dental caries.

Main Methods:

• Analysis of statewide oral health survey data from Ohio third graders.
• Classification of children's caries risk based on school lunch program enrollment and other non-clinical indicators.
• Comparison of sealant prevalence using chi-square tests, stratified by S-BSP availability and caries risk.

Main Results:

• Higher-risk children without S-BSPs had lower sealant prevalence (28.7%) compared to lower-risk children (42.7%).
• At schools with S-BSPs, sealant prevalence was similar for higher-risk (59.4%) and lower-risk (63.4%) children.
• Higher-risk children in S-BSP schools were over twice as likely to have sealants than those in non-S-BSP schools.

Conclusions:

• Targeting S-BSPs using school-level, income-based criteria effectively reached higher-risk children in Ohio.
• S-BSPs demonstrated success in achieving equitable sealant distribution across caries risk levels.
• These findings support the continued implementation and strategic targeting of S-BSPs for caries prevention.