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Dental sealants are typically placed on molar surfaces to prevent tooth decay, since molars are more prone to decay than other teeth. Children of low-income families are more likely to have decayed teeth than other children. Fortunately, all States now include sealants as a dental benefit for poor children enrolled in their Medicaid dental programs.
Dental sealants reduced the number of decayed tooth surfaces among Medicaid-insured children and had the most impact on children with more cavities before sealant placement. In addition, use of sealants saved Medicaid money for children prone to cavities, according to a study supported by the Agency for Healthcare Research and Quality (HS06993).
Medicaid and society will benefit by providing for sealant placement in cavity-prone children, concludes Gary Rozier, D.D.S., M.P.H., of the University of North Carolina, Chapel Hill. Dr. Rozier and his colleagues based their findings on assessment of the dental experiences of 15,438 children enrolled in the North Carolina Medicaid program from 1985 to 1992. They analyzed dental services for decay of permanent first molars (caries-related services involving the occlusal surface, CRSOs) and cumulative dental expenditures, controlling for characteristics of the child, treating dentist, and the child's county of residence.
Sealants were effective in preventing CRSOs, but they were most effective for children who had more dental services for cavities before sealant placement. Restoration rates (cavity fillings) for high-risk children peaked at 8 years for unsealed teeth and at 9 years for sealed teeth (18 vs. 8 percent). There were savings in Medicaid expenditures related to sealant use within 2 years of application for children with two or more prior CRSOs. The savings for sealed versus unsealed teeth peaked at $15.21 per child at 9 years for the high-risk group, and ranged from $9.54 at 9 years for the middle-risk group to $2.31 at 10 years for the low-risk group.
More details are in "Treatment outcomes and costs of dental sealants among children enrolled in Medicaid," by Jane A. Weintraub, D.D.S., M.P.H., Sally C. Stearns, Ph.D., Dr. Rozier, and Cheng-Chung Huang, M.P.H., in the November 2001 American Journal of Public Health 91(11), pp. 1877-1881.
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