School-Based Dental Sealant Programs in San Diego County: Why Prevention Matters

Tooth decay remains the most common chronic disease of childhood in the United States. According to the Centers for Disease Control and Prevention (CDC), more than half of children ages 6-8 have had at least one cavity in their primary teeth. Approximately 1 in 5 children aged 5-11 has at least one untreated cavity.

In San Diego County and across California, oral health disparities persist. While many families have consistent access to preventive dental care, others face structural barriers including transportation challenges, lack of insurance literacy, competing economic priorities, and limited availability of preventive services in their communities.

School-based dental sealant programs bring preventive oral health services directly into schools. Rather than relying on families to schedule and attend dental appointments offsite, these programs provide preventive services where children already spend most of their time.

Typically, a school-based dental sealant program includes oral health education, visual dental screenings, application of dental sealants to permanent molars, fluoride varnish application, and referral pathways for restorative needs.

The CDC reports that dental sealants can prevent up to 80% of cavities in molars for the first two years after placement and continue protecting against 50% of cavities for up to four years. Children without sealants have nearly three times more cavities than children with sealants.

The Community Preventive Services Task Force — an independent, nonfederal panel of public health experts — strongly recommends school-based dental sealant programs based on consistent evidence of effectiveness in reducing tooth decay among children.

Children experiencing dental pain may have difficulty concentrating in class. Untreated decay can disrupt sleep, affect nutrition, and contribute to behavioral challenges. When prevention is integrated into school settings, it supports not just oral health outcomes but broader educational equity.

Dental-related emergency department visits cost the United States billions annually. Many of these visits involve preventable conditions that could have been addressed earlier with routine preventive care. School-based dental sealant programs have been shown to be cost-effective by preventing cavities and reducing the need for restorative procedures.

CDC data shows that children from low-income households are significantly less likely to receive dental sealants compared to children from higher-income households. Yet they are more likely to experience untreated decay. School-based programs directly address this disparity by targeting communities where children are least likely to receive preventive care in traditional clinical settings.

California's Registered Dental Hygienist in Alternative Practice (RDHAP) model allows preventive services to be delivered in community settings outside traditional dental offices. This structure supports mobile and school-based delivery models that complement and strengthen comprehensive dental care.