5065.0: Wednesday, November 15, 2000 - 9:00 AM

Abstract #16045

School-based and school-linked sealant delivery programs in the Guide to Community Preventive Services

Benedict I. Truman, MD, MPH1, Barbara Gooch, DMD, MPH2, Helen C. Gift, PhD3, Alice Horowitz, PhD, MPH4, Iddrisu Sulemana, MA, MPH1, and Caswell A. Evans, DDS, MPH4. (1) Epidemiology Program Office/Division of Prevention Research and Analytic Methods, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K-73, Atlanta, GA 30341, 770-488-8227, bit1@cdc.gov, (2) NCCDPHP/Division of Oral Health, CDC, (3) Division of Social Sciences, Brevard College, (4) NIDCR, NIH

Objectives: School-based and school-linked sealant delivery programs deliver pit and fissure sealants directly to children who are underserved by private preventive dental services. This systematic literature review aimed to estimate the effectiveness of such programs in preventing or arresting occlusal caries, in comparison with no exposure to dental sealants. Methods: We searched Medline for evaluation studies published in English between 1966 and July, 1999; we also hand-searched published papers for related citations. Two reviewers independently evaluated each candidate study for quality of execution; the co-authors reconciled disagreements by consensus. Studies of any comparative design were eligible for inclusion in the final body of evidence if they had < 5 of 9 quality limitations and reported at least one effect measure of a difference in occlusal caries risk (control - intervention). Results: As of February 2000, 10 studies of sufficient quality yielded 22 measures of effectiveness. Of the 22 measures, 12 were derived from non-randomized trials, 4 from randomized trials, and 2 each from retrospective cohort, time series, and before-after studies. The median effect size was a 60% (range: 5 - 93%) reduction in occlusal caries due to sealants delivered in school-based (-linked) programs. For studies begun in the USA (including Guam) between 1970 and 1984, median effect size was 65% (range: 23% to 78%). Conclusions: The chapter coordination team judged the evidence to be strong based on quantity, quality, sufficient size, and consistent size and direction. The Guide's decision rule links a strong body of evidence to a strong recommendation for community action.

Learning Objectives: At the conclusion of this session, the participant (learner) in this session will be able to: 1. Describe the purpose of the Guide to Community Preventive Services (Guide). 2. List the six categories of interventions being evaluated in the Oral Health chapter of the Guide. 3. Describe the median and range of effect sizes reported for the effectiveness of school-based and school-linked sealant delivery programs evaluated and included in the final body of evidence. 4. Identify the strength of the evidence of effectiveness as determined by the Guide's criteria

Keywords: Sealant Programs, School-Based Programs

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA