Objectives: Dental sealant application has been estimated to reduce risk of caries by up to 80%, but does the dental providers ongoing assessment of caries risk change as a consequence of sealant application? The purpose of this study was to look at the factors associated with change in caries risk score.
Methods: This study was conducted at HealthPartners Dental Group. The population consisted of 2,307 children between the ages of 6 and 15 with a presealant elevated caries risk assessment (CRA) and a subsequent CRA at least three years later. All subjects had either a high or moderate risk, allowing the possibility of subsequent reduction in risk score. Analysis was conducted on change in risk score relative to gender, race (i.e. white vs. all other), education level, poverty level, income level and initial CRA. (Funded by HPRF 06-066)
Results: Among the study subjects, 53 % had a reduced CRA assessment after 3 years. Education level (p=0.73), poverty level (p=0.71) and income level (p=0.18), all proxies for SES had no significant relation with subsequent decline in CRA scores. Gender was also not related to decline in CRA score (p=0.73). However, race had a strong relationship with subsequent decline in CRA. Among white children 49% had a reduction in CRA score compared to 59% of non-white children (p=0.0007). Among the initial distribution of presealant CRA scores the minority population had 65% in the high risk category compared to 49% for the white children (p<0.0001).
Conclusions: Since only about half the children receiving sealants received a subsequent reduction in CRA, sealants may not have been perceived by dental health professionals as sufficient to reduce levels of risk. However, caries risk is considered relative to factors associated with increased risk but little attention is given to treatments that reduce risk.