Abstract
Background: 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 were 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 8458 children 6 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 7986 subjects. CRAs were classified into 3 scores; low, moderate and high and all analyses were made relative to the first caries risk assessment at age 6.
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 6 months of their CRA while among the children with moderate or high risk, 26% and 27% had subsequent sealant within 6 months (P<0.0001). When the 6-month follow-up timeframe to include any later sealant was lifted, sealant rates were 69%, 69% and 67% (P=0.19).
Conclusions: First, higher risk children are composed of significantly more children from lower socioeconomic status. Second, it appears that when a child of 6 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.
- Received September 11, 2008.
