ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1995.tb02379.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1995.tb02380.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1995.tb02381.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThis paper reviews recent changes in the epidemiology of dental caries and assesses their potential impact on the diagnosis and management of the disease and the planning and operation of sealant programs. These changes, such as the decline in caries and slowing of the rate of progression of the disease, have important implications for diagnosing and treating incipient lesions, predicting caries risk, and conducting effective disease preventive programs. Traditional paradigms for restoring carious lesions are being replaced by newer strategies that emphasize disease prevention and conservation of tooth structure. The search continues for the identification of practical models for predicting caries risk at the individual level. This paper describes a method useful for targeting resources in sealant placement programs by enabling one to determine the relative effectiveness of sealing alternative tooth surfaces in the oral cavity. One guide serves as a widely adopted manual for those who use or intend to use dental sealants in caries prevention programs. This paper provides a brief review of that document, “Preventing Pit and Fissure Caries: A Guide to Sealant Use,” as well as guidelines for sealant utilization provided by the American Dental Association, and information regarding dental sealant programs under Medicaid. The final portion of the paper provides a synthesis of the epidemiology reviewed and summarizes the implications of findings for sealant progr

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1995.tb02382.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1995.tb02383.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SummaryWhen used properly, sealants result in improved dental health. However, their use on all occlusal tooth surfaces for preventive reasons will result in wasted dental care resources. To optimize the preventive effects of sealants, a delivery model should be initiated that uses specially trained dental hygienists or dental assistants who visit schools to explain oral health‐related issues, conduct visual inspections of clinical oral health status, identify patients at risk for dental caries, and generate a central database for program operation. When a high‐risk patient is identified, auxiliary personnel could place sealants and recall the patient for a new visual inspection six months later. If caries is suspected at that time, the patient could be sent to a dentist for additional treatment.To offset the negative effects caused by overutilization of sealants, their usage should be divided into two categories. First, a preventive option should be available, and the fee for use of sealants in this option should be lower compared to the fees used today. By using specially trained auxiliary personnel to place such sealants, the fee could be kept reasonably low. Second, a sealant treatment option that targets treatments of incipient lesions also should be available. The fee for such a treatment should be close to that of the traditional occlusal restoration, and the application should be by a dentist.By using such a fee structure based on market forces, one would expect that sealant usage would increase among patients suffering from early carious lesions, while the usage of preventive sealants would remain the same or decline. This utilization pattern for dental sealants would contribute to improved efficiency of sealant usage in the treatment of dental caries, particularly at a time when caries frequency is declining. The improved efficiency could release dental care resources that should be used to target risk groups with improved education in dental health. By using such a strategy, the long‐term effect would be not only the placement of fewer restorations, but an improvement in dental health among adolescents and a

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1995.tb02384.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1995.tb02385.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY