Key Findings

Although a number of states are making progress, most of them have a great deal of work to do if they intend to make prevention a priority. Indeed, 40 percent of all states earned a grade of D or F on Pew’s benchmarks:

• Thirty-five states and the District of Columbia do not have sealant programs in a majority of high-need schools—those with a high proportion of children most at risk of decay. Unfortunately, four states have no programs in these schools.
• Nineteen states and D.C. still maintain a regulation that restricts hygienists’ ability to provide sealants to more children.  This outdated rule requires a dentist to examine a child before a hygienist can place a sealant, ignoring the evidence showing this prerequisite is unnecessary.  Even states that have passed laws to remove these barriers need to take additional steps.  For example, Arkansas removed this restriction in 2011, but the state Board of Dentistry has not yet released regulations to implement this law.
• Forty states and D.C. could not confirm that they had reached at least 50 percent of their children with sealants. This is the minimum threshold established by Healthy People 2010, a national set of disease-prevention objectives that were developed by federal health officials.
• Collecting recent data on tooth decay and other dental health measures is essential for states to make informed and strategic policy decisions. Yet 19 states and D.C. did not submit data from within the past five years on school-aged children to the National Oral Health Surveillance System (NOHSS), a database that enables policy makers to identify trends and assess progress.
• Only five states earned an A, and only two of them (Maine and New Hampshire) received the maximum points possible. Yet, even in these five states, there is room for improvement because thousands of children who are most at risk for decay are not receiving sealants.
• Eight states received a B. Of these states, five failed to meet the Healthy People 2010 objective and half did not have sealant programs in a majority of high-need schools.
• Seventeen states earned C grades, and another 15 received D’s. The D states have significant room for improvement.
• Five states—Hawaii, New Jersey, Montana, North Carolina, and Wyoming—and the District of Columbia earned an F. They are lagging far behind in prevention efforts.

Learn more from our 50-state fact sheets.

Related Infographic: Most States Lag on Dental Sealants

Report Assets