{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:59:31Z","timestamp":1790391571979,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["R21DE032149"],"award-info":[{"award-number":["R21DE032149"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Public Health Dent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Despite the availability of effective preventive dental services, caries prevalence remains high. In this study, we examined the relationship between untreated molar caries (UMC) on the permanent molars of adolescents and the presence of dental sealants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Our study population included all adolescents aged 12\u201319\u2009years and those from low\u2010income households. We used National Health and Nutrition Examination Survey data (2011\u20132016). Our outcome was UMC, and the primary exposure was the presence of at least one sealant on second molars (2M), first molars (1M), or both. We examined the association between UMC and sealant status using bivariate analyses and multivariable logistic regression models controlling for socioeconomic and other covariates. All analyses were weighted and accounted for complex survey data;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 was considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among adolescents (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093601), 15.3% had UMC, and 55.7% experienced caries in permanent molars. Molar sealant prevalence was 30.8%, while 12.8% and 3.8% had only 1M and 2M sealants, respectively. Adolescents without sealants had a higher prevalence of UMC than those with 1M, 2M, or both sealants (22.3% vs. 10.6%, 8.0%, and 6.2%, respectively). Adjusted models indicated that adolescents with both 1M and 2M sealants had 72% lower odds of UMC than those without sealants (OR\u2009=\u20090.28, 95% CI: 0.18, 0.44). Findings were similar but more pronounced for adolescents in low\u2010income households.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of UMC is significantly higher among adolescents without sealants. Oral health programs should promote and prioritize sealants, especially for 2M, to improve adolescent oral health and reduce the burden of dental caries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jphd.70079","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:13:20Z","timestamp":1790388800000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Relationship Between Untreated Molar Caries and Dental Sealants Among US Adolescents"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5586-5843","authenticated-orcid":false,"given":"Shillpa","family":"Naavaal","sequence":"first","affiliation":[{"name":"Pediatric Dentistry and Dental Public Health and Policy, School of Dentistry Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9671-628X","authenticated-orcid":false,"given":"Christina","family":"Scherrer","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, Southern Polytechnic College of Engineering and Engineering Technology Kennesaw State University  Kennesaw Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Tatro","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services Kennesaw State University  Kennesaw Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan O.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Terra Integrated Solution  State College Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.14485\/HBPR.5.2.7","article-title":"School Hours Lost due to Acute\/Unplanned Dental Care","volume":"5","author":"Naavaal S.","year":"2018","journal-title":"Health Behavior and Policy Review"},{"issue":"10","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.2105\/AJPH.2010.200915","article-title":"Impact of Poor Oral Health on Children's School Attendance and Performance","volume":"101","author":"Jackson S. L.","year":"2011","journal-title":"American Journal of Public Health"},{"issue":"1","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-92523-6","article-title":"Investigating the Link Between Oral Health Conditions and Systemic Diseases: A Cross\u2010Sectional Analysis","volume":"15","author":"Natarajan P.","year":"2025","journal-title":"Scientific Reports"},{"issue":"5","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1159\/000448599","article-title":"Early Caries Predicts Low Oral Health\u2010Related Quality of Life at a Later Age","volume":"50","author":"Kragt L.","year":"2016","journal-title":"Caries Research"},{"key":"e_1_2_11_6_1","volume-title":"Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States: 1999\u20132004 to 2011\u20132016","author":"Lin M.","year":"2019"},{"issue":"4","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.adaj.2021.01.003","article-title":"The Contribution of Different Permanent Tooth Types to Untreated Caries: Implications for Public Health Surveillance and Prevention","volume":"152","author":"Griffin S. O.","year":"2021","journal-title":"Journal of the American Dental Association"},{"issue":"6","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.18425","article-title":"Analysis of Race and Ethnicity, Socioeconomic Factors, and Tooth Decay Among US Children","volume":"6","author":"Choi S. E.","year":"2023","journal-title":"JAMA Network Open"},{"key":"e_1_2_11_9_1","volume-title":"Oral Health in America: Advances and Challenges","author":"National Institutes of Health","year":"2021"},{"key":"e_1_2_11_10_1","unstructured":"\u201cReduce the Proportion of Children and Adolescents With Lifetime Tooth Decay\u2014OH\u201001 \u201dHealthy People 2030 accessed November 7 2025 https:\/\/odphp.health.gov\/healthypeople\/objectives\u2010and\u2010data\/browse\u2010objectives\/oral\u2010conditions\/reduce\u2010proportion\u2010children\u2010and\u2010adolescents\u2010lifetime\u2010tooth\u2010decay\u2010oh\u201001."},{"key":"e_1_2_11_11_1","unstructured":"\u201cReduce the Proportion of Children and Adolescents With Active and Untreated Tooth Decay\u2014OH\u201002 \u201dHealthy People 2030. accessed November 7 2025 https:\/\/odphp.health.gov\/healthypeople\/objectives\u2010and\u2010data\/browse\u2010objectives\/oral\u2010conditions\/reduce\u2010proportion\u2010children\u2010and\u2010adolescents\u2010active\u2010and\u2010untreated\u2010tooth\u2010decay\u2010oh\u201002."},{"key":"e_1_2_11_12_1","article-title":"Pit and Fissure Sealants for Preventing Dental Decay in Permanent Teeth","volume":"7","author":"Ahovuo\u2010Saloranta A.","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"12","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1377\/hlthaff.2016.0839","article-title":"School\u2010Based Dental Sealant Programs Prevent Cavities and Are Cost\u2010Effective","volume":"35","author":"Griffin S.","year":"2016","journal-title":"Health Affairs"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2016.06.001"},{"key":"e_1_2_11_15_1","unstructured":"\u201cIncrease the Proportion of Children and Adolescents Who Have Dental Sealants on 1 or More Molars\u2014OH\u201010 \u201dHealthy People 2030 accessed November 24 2025 https:\/\/odphp.health.gov\/healthypeople\/objectives\u2010and\u2010data\/browse\u2010objectives\/oral\u2010conditions\/increase\u2010proportion\u2010children\u2010and\u2010adolescents\u2010who\u2010have\u2010dental\u2010sealants\u20101\u2010or\u2010more\u2010molars\u2010oh\u201010."},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.15585\/mmwr.mm6541e1","article-title":"Vital Signs: Dental Sealant Use and Untreated Tooth Decay Among US School\u2010Aged Children","volume":"65","author":"Griffin S. O.","year":"2016","journal-title":"Morbidity and Mortality Weekly Report"},{"issue":"10","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.adaj.2024.07.010","article-title":"Second Molar Sealants Among US Adolescents and Their Association With Select Sociodemographic Factors and First Molar Sealants: A Cross\u2010Sectional Study Using National Health and Nutrition Examination Survey Data","volume":"155","author":"Naavaal S.","year":"2024","journal-title":"Journal of the American Dental Association"},{"key":"e_1_2_11_18_1","unstructured":"Centers for Disease Control and Prevention \u201cNational Health and Nutrition Examination Survey \u201daccessed November 24 2025 https:\/\/www.cdc.gov\/nchs\/nhanes\/index.html."},{"issue":"6","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2019-3150","article-title":"Unique Needs of the Adolescent","volume":"144","author":"Alderman E. M.","year":"2019","journal-title":"Pediatrics"},{"issue":"5","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1034\/j.1600-0528.2003.00016.x","article-title":"Time and Duration of Eruption of First and Second Permanent Molars: A Longitudinal Investigation","volume":"31","author":"Ekstrand K. R.","year":"2003","journal-title":"Community Dentistry and Oral Epidemiology"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","DOI":"10.5888\/pcd16.180398","article-title":"Awareness Among US Adults of Dental Sealants for Caries Prevention","volume":"16","author":"Junger M. L.","year":"2019","journal-title":"Preventing Chronic Disease"},{"issue":"1","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/jphd.12171","article-title":"The Effect of Health and Dental Insurance on US Children's Dental Care Utilization for Urgent and Non\u2010Urgent Dental Problems\u20102008","volume":"77","author":"Naavaal S.","year":"2017","journal-title":"Journal of Public Health Dentistry"},{"key":"e_1_2_11_23_1","volume-title":"Oral Health: Preventing Dental Caries, School\u2010Based Dental Sealant Delivery Programs","author":"Community Preventive Services Task Force","year":"2024"},{"issue":"5","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1177\/00220345241231774","article-title":"Exploring Recent Decreases in First Molar Sealants Among US Children","volume":"103","author":"Lin M.","year":"2024","journal-title":"Journal of Dental Research"},{"issue":"10","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1177\/00220345221090183","article-title":"COVID\u201019 Pandemic Impact on US Childhood Caries and Potential Mitigation","volume":"101","author":"Scherrer C.","year":"2022","journal-title":"Journal of Dental Research"}],"container-title":["Journal of Public Health Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jphd.70079","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jphd.70079","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jphd.70079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:13:25Z","timestamp":1790388805000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jphd.70079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":24,"alternative-id":["10.1111\/jphd.70079"],"URL":"https:\/\/doi.org\/10.1111\/jphd.70079","archive":["Portico"],"relation":{},"ISSN":["0022-4006","1752-7325"],"issn-type":[{"value":"0022-4006","type":"print"},{"value":"1752-7325","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"assertion":[{"value":"2025-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jphd.70079"}}