{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:26:24Z","timestamp":1791887184135,"version":"4.3.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in \u22651 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods ( P &lt; 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner\u2019s replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.<\/jats:p>","DOI":"10.1177\/00220345241231774","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T04:21:18Z","timestamp":1709007678000},"page":"509-515","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Exploring Recent Decreases in First Molar Sealants among US Children"],"prefix":"10.1177","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1716-7849","authenticated-orcid":false,"given":"M.","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0016-6556","authenticated-orcid":false,"given":"S. O.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. H.","family":"Li","sequence":"additional","affiliation":[{"name":"CyberData Technologies, Inc., Herndon, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Wei","sequence":"additional","affiliation":[{"name":"DB Consulting Group, Inc., Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Thornton-Evans","sequence":"additional","affiliation":[{"name":"Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"bibr1-00220345241231774","unstructured":"Adunola S. 2022. HRSA annual update UDS dental sealants measure [accessed 2023 Dec 8]. https:\/\/www.nnoha.org\/items-2\/2022-annual-update-on-the-uds-sealant-measure\u2014seal-the-deal."},{"key":"bibr2-00220345241231774","unstructured":"Agency for Healthcare Research and Quality. 2021. Medical Expenditure Panel Survey: general FAQs [accessed 2023 Dec 8]. https:\/\/meps.ahrq.gov\/communication\/participants\/faq_gen_mpc.shtml."},{"key":"bibr3-00220345241231774","unstructured":"Agency for Healthcare Research and Quality. 2022. MEPS-HC panel design and data collection process [accessed 2023 Dec 8]. https:\/\/meps.ahrq.gov\/survey_comp\/hc_data_collection.jsp."},{"key":"bibr4-00220345241231774","unstructured":"Agency for Healthcare Research and Quality. 2023. Medical Expenditure Panel Survey Household Component response rates [accessed 2023 Dec 8]. https:\/\/meps.ahrq.gov\/survey_comp\/hc_response_rate.jsp."},{"issue":"7","key":"bibr5-00220345241231774","volume":"7","author":"Ahovuo-Saloranta A","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"bibr6-00220345241231774","first-page":"273","volume":"19","author":"Aranda M","year":"1995","journal-title":"J Clin Pediatr Dent"},{"key":"bibr7-00220345241231774","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2008.0155"},{"key":"bibr8-00220345241231774","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp440"},{"key":"bibr9-00220345241231774","unstructured":"Centers for Disease Control and Prevention. 2021. NHANES response rates and population totals [accessed 2022 Dec 21]. https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/responserates.aspx."},{"key":"bibr10-00220345241231774","unstructured":"Centers for Disease Control and Prevention. 2019a. Oral health surveillance report: trends in dental caries and sealants, tooth retention, and edentulism, United States, 1999\u20132004 to 2011\u20132016 [accessed 2022 Mar 21]. https:\/\/www.cdc.gov\/oralhealth\/publications\/OHSR-2019-index.html."},{"key":"bibr11-00220345241231774","unstructured":"Centers for Disease Control and Prevention. 2019b. State-based oral health programs [accessed 2022 Mar 21]. https:\/\/www.cdc.gov\/oralhealth\/funded_programs\/index.htm."},{"key":"bibr12-00220345241231774","unstructured":"Centers for Disease Control and Prevention. 2022. National Health and Nutrition Examination Survey: NCHS Ethics Review Board (ERB) approval [accessed 2023 Dec 8]. https:\/\/www.cdc.gov\/nchs\/nhanes\/irba98.htm."},{"key":"bibr13-00220345241231774","unstructured":"Centers for Disease Control and Prevention. 2023a. National Health and Nutrition Examination Survey [accessed 2023 Dec 8]. https:\/\/www.cdc.gov\/nchs\/nhanes\/index.htm."},{"key":"bibr14-00220345241231774","unstructured":"Centers for Disease Control and Prevention. 2023b. NOHSS child indicators [accessed 2023 July 10]. https:\/\/data.cdc.gov\/Oral-Health\/NOHSS-Child-Indicators\/qcai-zfj9\/about_data."},{"key":"bibr15-00220345241231774","unstructured":"Centers for Medicare & Medicaid Services. 2019. Annual EPSDT participant report: form CMS-416 [accessed 2022 Aug 29]. https:\/\/www.medicaid.gov\/medicaid\/benefits\/early-and-periodic-screening-diagnostic-and-treatment\/index.html."},{"key":"bibr16-00220345241231774","unstructured":"Centers for Medicare & Medicaid Services. 2022. Core Set of Children\u2019s Health Care Quality Measures [accessed 2022 Mar 10]. https:\/\/www.medicaid.gov\/medicaid\/quality-of-care\/performance-measurement\/adult-and-child-health-care-quality-measures\/childrens-health-care-quality-measures\/index.html."},{"key":"bibr17-00220345241231774","unstructured":"Community Preventive Services Task Force. 2013. Dental caries (cavities): school-based dental sealant delivery programs. [accessed 2022 Mar 21]. https:\/\/www.thecommunityguide.org\/findings\/dental-caries-cavities-school-based-dental-sealant-delivery-programs."},{"issue":"248","key":"bibr18-00220345241231774","first-page":"1","volume":"11","author":"Dye BA","year":"2007","journal-title":"Vital Health Stat"},{"key":"bibr19-00220345241231774","unstructured":"Global Burden of Disease Collaborative Network. 2020. GBD results tool: Global Burden of Disease study 2019 (GBD 2019) results. Seattle (WA): Institute for Health Metrics and Evaluation (IHME) [accessed 2022 Aug 29]. https:\/\/vizhub.healthdata.org\/gbd-results\/."},{"key":"bibr20-00220345241231774","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6541e1"},{"key":"bibr21-00220345241231774","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2021.01.003"},{"key":"bibr22-00220345241231774","unstructured":"Hilton I, Maas B, Wright M. 2020. Dental sealants in the COVID-19 world [accessed 2023 Dec 8]. https:\/\/www.nnoha.org\/pages-1\/resources-%7C-webinars-slides-%26-recordings."},{"key":"bibr23-00220345241231774","first-page":"1","volume":"20","author":"Klein RJ","year":"2001","journal-title":"Healthy People 2010 Stat Notes"},{"key":"bibr24-00220345241231774","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"bibr25-00220345241231774","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0077103"},{"key":"bibr26-00220345241231774","unstructured":"National Association of Community Health Centers and DentaQuest Partnership for Oral Health Advancement. 2020. Oral health value-based care: the Federally Qualified Health Center (FQHC) story [accessed 2023 Dec 8]. https:\/\/www.nachc.org\/resource\/oral-health-value-based-care-the-federally-qualified-health-center-fqhc-story\/."},{"key":"bibr27-00220345241231774","unstructured":"US Department of Health and Human Services. 2021. Health benefits & coverage: dental coverage in the Marketplace. [accessed 2023 Dec 8]. https:\/\/www.healthcare.gov\/coverage\/dental-coverage\/."},{"key":"bibr28-00220345241231774","unstructured":"US Department of Health and Human Services. 2022. Healthy People 2030: building a healthier future for all [accessed 2023 Dec 8]. https:\/\/health.gov\/healthypeople."},{"key":"bibr29-00220345241231774","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12678"},{"key":"bibr30-00220345241231774","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2016.06.001"},{"key":"bibr31-00220345241231774","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2016.06.003"}],"container-title":["Journal of Dental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00220345241231774","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00220345241231774","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00220345241231774","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:08:41Z","timestamp":1777496921000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00220345241231774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,27]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1177\/00220345241231774"],"URL":"https:\/\/doi.org\/10.1177\/00220345241231774","relation":{},"ISSN":["0022-0345","1544-0591"],"issn-type":[{"value":"0022-0345","type":"print"},{"value":"1544-0591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,27]]}}}