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Jane A. Weintraub, DDS, MPH, Sally C. Stearns, PhD, R. Gary Rozier, DDS, MPH and Cheng-Chung Huang, MPH

Jane A. Weintraub is with the Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco. Sally C. Stearns, R. Gary Rozier, and Cheng-Chung Huang are with the Department of Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill.

Correspondence: Requests for reprints should be sent to Jane A. Weintraub, DDS, MPH, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, 3333 California St, Suite 495, San Francisco, CA 94118–1361 (e-mail: janew{at}itsa.ucsf.edu).

Objectives. This retrospective cohort analysis of children enrolled in the North Carolina Medicaid program compared the likelihood of restorative treatments and associated cumulative Medicaid expenditures for teeth with or without dental sealants.

Methods. We assessed the dental experience of the cohort of 15 438 children from 1985 to 1992 on the basis of enrollment and claims files. We conducted regression analyses for outcomes (caries-related services involving the occlusal surface [CRSOs] of permanent first molars) and cumulative expenditures, controlling for characteristics of the child, the treating dentist, and the child's county of residence.

Results. Overall, 23% of children received at least 1 sealant and 33% at least 1 CRSO. Sealants were effective in preventing CRSOs, although the degree of effectiveness was highest for children with the greater levels of CRSOs before sealant placement. Estimated cumulative Medicaid expenditures indicated expenditure savings from sealants within 2 years of application for children with 2 or more prior CRSOs.

Conclusions. Sealant placement was associated with expenditure savings to Medicaid for certain high-risk children, so Medicaid and, more broadly, society will benefit by providing for sealant placement in these children.

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