Objective: The purpose of this investigation was to examine the relationship between a caries risk assessment (CRA) score and the subsequent application of sealants.
Methods: Data was collected from the data sets of a large dental managed care organization in Minnesota. Sealant placement was a covered benefit in the study period. This study was conducted using the data from 8,458 children six years of age between 1995 and 2006. Six percent of the subjects (472) had a prior history of a sealant at the time of their first CRA and were therefore excluded. This left 7,986 subjects. CRAs were classified into three scores; low, moderate and high and all analyses were made relative to the first caries risk assessment at age six.
Results: The distribution of initial CRAs found 61.4% with low risk, 15.3% with moderate and 23.3% at high risk. In the high risk category 36.9% of children had dental coverage through public programs verses 18.8% for the low risk group (p<0.001). Of the children at low risk 19% received a sealant within six months of their CRA while among the children with moderate or high risk 26% and 27% had subsequent sealant within six months (p<.0001). When the six-month follow-up timeframe to include any later sealant was lifted, sealant rates were 69%, 69% and 67% (p=.19).
Conclusions: First, higher risk children are composed of significantly more children from lower SES status. Second, it appears that when a child of six years of age is assessed to be at high risk for the development of subsequent caries they are more likely to receive a sealant within the period following the caries risk assessment. However, as the interval after the caries risk assessment lengthens other factors impact the likelihood of a sealant application in the low risk group and their rate approaches that of the high risk children.