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

Objectives: This report compares sealant prevalence by caries risk status among third graders at Ohio schools with and without school-based dental sealant programs (S-BSPs), and estimates the percent of children receiving sealants in S-BSPs who are higher risk for dental caries. Methods: We analyzed data from a statewide open-mouth oral health survey of Ohio third grade schoolchildren for sealant prevalence by S-BSP availability and caries risk classification. Children were classified as higher or lower risk for dental caries based on school lunch program enrollment and other non-clinical access-related indicators. Differences between groups were evaluated by the chi-square test (P < 0.05). Results: At schools with no S-BSPs, higher risk children were less likely to have dental sealants than lower risk children (28.7 percent versus 42.7 percent, P < 0.001). At schools with S-BSPs, sealant prevalence for both risk categories was equivalent for higher and lower risk children (59.4 percent, 63.4 percent, P = 0.428). Higher risk children at schools with S-BSPs were more than twice as likely to have a sealant as higher risk children at non-S-BSP schools (59.4 percent versus 28.7 percent, P < 0.001). Of higher risk children with at least one sealant, 61 percent attended a school with an S-BSP compared with 12.3 percent of lower risk children with at least one sealant. Higher risk children accounted for at least 75 percent of children receiving sealants through S-BSPs. Conclusions: In Ohio, targeting S-BSPs by family income-based school-level criteria was effective in reaching higher risk children.