Community-based Sealant Programs in the United States: Results of a Survey

The appropriate use of pit and fissure sealants could reduce substantially the majority of occlusal caries among US school-aged children. The 1986–87 national oral health survey conducted by the NIDR showed that less than 8 percent of the children 5–17 years of age had sealants on their teeth. The purpose of this national study was to document the current status of community-based sealant programs and to identify general program characteristics. Data were gathered through a mail survey to all state dental directors and site visits to four selected comprehensive community-based programs. Twentynine states were currently conducting sealant programs. The vast majority of these programs had formal quality assurance systems and companion health education components. Eight states indicated that sealant programs had been terminated within the last two years. Medicaid reimbursement for sealants was available in 42 states, with a mean reimbursement rate of $10.71 per sealant. Reimbursement rates ranged from $3.00- $20.00 per sealant. State practice acts almost uniformly permitted the placement of sealants by dental hygienists (n = 48), but less frequently by dental assistants (n = 15). Approximately 43 percent of state practice acts did not require a dentist to be present physically when auxiliaries place sealants in public/community sealant programs. All respondents indicated that there was a need for additional programs in their state. No structural factors—for example, level of Medicaid reimbursement for sealants or state practice act requirements for auxiliary supervision—were found to be associated with the presence of community-based sealant programs. Nationally, only a small percentage of children appeared to be receiving sealants in community programs.     

Book Reviews

Book reviewed in this article:
Wei SHY, ed. CLINICAL USES OF FLUORIDE.
Nikiforuk G. UNDERSTANDING DENTAL CARIES VOL 1; ETIOLOGY AND MECHANISMS. BASIC AND CLINICAL ASPECTS.
Weintraub JA, Douglass CW, Gillings DB. BIOSTATS: DATA ANALYSIS FOR DENTAL HEALTH CARE PROFESSIONALS
Besford J. GOOD MOUTHKEEPING.
Manson-Hing LR. FUNDAMENTALS OF DENTAL RADIOGRAPHY.
Eversole LR. CLINICAL OUTLINE OF ORAL PATHOLOGY, 2nd ed.     

Issues in the Widespread Adoption of Pit-and-Fissure Sealants

Seven issues affecting the use of sealants have been discussed, and five strategies have been suggested to promote their wider use in private and public settings. A strong initiative by industry, in conjunction with organized dentistry and government, is needed to generate public demand and to promote appropriate use by practitioners and auxiliaries. The most fruitful market for sealants at present and in the future may be through public health programs using dental auxiliaries, because the primary prevention of dental caries is stressed more in this area, whereas private practitioners tend to focus more on treating caries. During these times of financial restriction, there is all the more reason to focus effective caries prevention on those tooth surfaces that develop more than half of all carious lesions. The most efficient use of the limited private and public funds that are available to promote oral health must be made. Given the new sealant materials available and the opportunity to delegate their application to auxiliary personnel in both private and public practice, the challenge now is to promote the widespread use of this technology in conjunction with appropriate fluorides so that no child is denied the opportunity to enjoy a caries-free dentition.     

Development of an Oral Health Survey: Columbus, Ohio

This article describes the method used to develop and implement a local oral health survey (Columbus, Ohio) conducted in 1986. With the shift in the national dental disease pattern in the past decade, local oral health information is essential for program planning purposes. A collaborative effort by a city health department, a state health department, a dental school, and a school of public health demonstrated how this group worked harmoniously in a relatively inexpensive venture to determine the oral status of various age groups (grades 1-2, grades 6-7, age 35-44, and age 65+). This information provided part of the framework for a five-year dental plan at the Columbus Health Department. The survey design will serve as a basis for conducting a similar survey statewide. Modifications of existing oral health survey instruments are discussed.     

A Symposium on the Future of Dentistry Report: Implications for the Public Sector: Impact on Dental Hygiene

This paper reviews the six recommendations as approved by the House of Delegates of the American Dental Association in 1983. Each recommendation is reviewed in relation to public health and preventive dentistry as well as the established goal of dental hygiene: "To improve the public's total health by increasing the awareness of and access to quality oral health care and to position the dental hygienist as the preventive oral health professional." To reach this goal it is recommended that dental hygienists seek out opportunities in the public sector where there is more job satisfaction, their professional roles have higher acceptance with both coworkers and patients, and there is a high level of interaction with other health-care professionals.     

A Symposium on Building a Coalition To Improve the Public's Oral Health: Dental Hygiene's New Initiative—How Can We Work Together?

This presentation speaks to many issues upon which the American Dental Hygienists' Association and the American Public Health Association agree. The boundaries are limitless for ADHA and APHA to work together to increase access to preventive care and to establish the dental hygienist as the provider to preventive dental care. Shaping the Nation's Health Agenda through coalition building is a way to the future for total body wellness and optimum oral health.