By Nancy Volkers
InteliHealth News Service

Dental sealants reduced the number of fillings and extractions by about 67 percent in a group of low-income children from North Carolina, according to the results of an eight-year study. Sealants are a thin coat of plastic applied to the chewing surfaces of healthy teeth. They are used to protect the teeth from decay-causing bacteria.

The study followed 15,438 Medicaid-enrolled children from about ages 5 to 13. The researchers focused on the children's first permanent molars (which also are called six-year molars because they tend to come in around age 6). Of the children, 23 percent received a sealant on at least one six-year molar.

The sealants reduced the risk of decay in low-risk children for four years, in middle-risk children for six years, and in high-risk children for the full seven years of the study. From the Medicaid program's perspective, the sealants were cost-effective in children at high risk for decay, but were not worth the cost to apply them to all children.

The researchers divided children into the low-, middle- and high-risk groups based on how many times they had already been treated for tooth decay.

"The sealants were very effective for all the kids, but when we started comparing costs, we got the most benefit in the high-risk kids because there was more disease being prevented in that group," said Jane A. Weintraub, D.D.S., M.P.H., who was at the University of North Carolina, Chapel Hill at the time of the study. Weintraub is now at the School of Dentistry at the University of California, San Francisco.

"With any kind of prevention program, the initial upfront costs are high," Weintraub said. "And right now, we don't have a good way of knowing whether 5- or 6-year-olds are going to get tooth decay in the future or not."

The goal, she said, is some day to be able to identify high-risk kids before they get any cavities at all.

Weintraub said she "absolutely recommends" sealants to anyone who is considering them. "From an individual's perspective, if they're most concerned about preventing [decay], they should get sealants," she said. "That goes for adults, as well as kids."

The research was published in the November issue of the American Journal of Public Health.