Evaluation of School-Based Sealant Programs: Thailand's National Oral Health Policy, 2020, focuses on giving children ages 6 to 12 access to oral health care
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Abstract
Thailand's Ministry of Public Health and National Health Security Office implemented a policy in 2020 to increase access to sealant services through the financial health system and reduce caries prevalence. The purposes of the study were to 1) examine coverage of sealant services and 2) explore associated factors with one-year sealant retention and dental caries. Children aged 6 to 12 receiving sealant services between October 2019 and February 2020 were recruited. This analytical cross-sectional study was conducted between January and February 2021. Two-stage stratified sampling was performed in 12 provinces, and four schools were randomly selected. The results showed that the coverage of sealant services increased from 12.1% to 25.4%. Sealant retention and caries on sealed surfaces were examined in 3,674 students from 59 schools. There were 8,893 surfaces sealed with 2.4 teeth per child on average. The percentages of complete retention, partial loss, and total loss were 27.5%, 42.6% and 29.9%, respectively. Initial carious and cavitated lesions were found in 15.9% and 3.1% of those sealed teeth. The key factors significantly associated with sealant failures were place of service (p<0.001), dental assistant (p<0.001), sealed teeth per visit (p=0.011) and oral hygiene (p<0.001). Age, gender, and oral hygiene were significantly associated with dental caries incidence (p<0.001). This policy demonstrates the increase in sealant service coverage, but the effectiveness in terms of retention and caries prevention is low. Thus, enhancing the school dental program through both quality treatment and preventive interventions could reduce the risk of dental caries.
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