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Dental Caries (Cavities): Community-Based Initiatives to Promote the Use of Dental Sealants


What the CPSTF Found

About The Systematic Review

The Task Force finding is based on evidence from a systematic review of three studies (search period 1946-2012). The systematic review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to oral health. This finding updates and replaces the 2000 review on Statewide or Community-Wide Sealant Promotion [PDF - 215 kB].


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Summary of Results

Included studies evaluated interventions that used education, mass media, financial incentives, or a combination of these methods.

  • One intervention offered financial incentives to dental health professionals and saw a significant 9.8 percentage point increase in the number of children who received sealants.
  • Neither education (2 study arms) nor mass media (1 study) showed significant effects on sealant use.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the Task Force did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the Task Force did not have enough information to determine if the intervention works.

Evidence Gaps

Each Community Preventive Services Task Force (Task Force) review identifies critical evidence gaps—areas where information is lacking. Evidence gaps can exist whether or not a recommendation is made. In cases when the Task Force finds insufficient evidence to determine whether an intervention strategy works, evidence gaps encourage researchers and program evaluators to conduct more effectiveness studies. When the Task Force recommends an intervention, evidence gaps highlight missing information that would help users determine if the intervention could meet their particular needs. For example, evidence may be needed to determine where the intervention will work, with which populations, how much it will cost to implement, whether it will provide adequate return on investment, or how users should structure or deliver the intervention to ensure effectiveness. Finally, evidence may be missing for outcomes different from those on which the Task Force recommendation is based.

Identified Evidence Gaps

  • More evidence is needed to assess the effectiveness of community-based sealant promotion initiatives for increasing sealant use.
  • Additionally, research should be done to better understand dental health professionals' beliefs and other barriers that prevent change with regard to sealant application.

Study Characteristics

  • Included evidence comes from the United States (2 studies) and the United Kingdom (1 study).
  • Studies reported the percentage of children who received sealants, the number of sealants applied per child, and the extent of sealant use among dentists.