Variation in General Dentists' Patterns of Sealant Use in Children with Elevated Caries Risk

Area of Science:

• Dental Public Health
• Pediatric Dentistry
• Health Services Research

Background:

• Dental sealants are proven effective in preventing tooth decay, with guidelines recommending their use in high-risk children.
• Despite recommendations, a gap exists between indicated and actual sealant application in pediatric dental care.

Purpose of the Study:

• To investigate variations in general dentists' application of dental sealants for pediatric patients identified as high-risk for caries.
• To identify dentist-level factors associated with the utilization of sealants in this population.

Main Methods:

• A cohort of 27,677 children (ages 6-17) with elevated caries risk and 818 general dentists were identified from private dental program data (2010-2014).
• Elevated caries risk was determined by restorative treatment history.
• A two-stage hurdle model analyzed sealant provision (any use and extent of use) during a 2-year observation period (2013-2014), focusing on dentist characteristics.

Main Results:

• 13.3% of dentists provided no sealants to high-risk children.
• Female dentists were more likely to use sealants (OR=2.27). Dentist age and rural practice location were negatively associated with any sealant use.
• Among dentists using sealants, female, older, solo-practicing, and full-time dentists were more likely to provide them.

Conclusions:

• Significant provider-level variation exists in dental sealant use among high-risk pediatric patients.
• Findings offer a foundation for interventions to increase sealant uptake and reduce oral health disparities.
• Further research into clinician motivations and barriers for preventive interventions is warranted.