The Relationship Between Untreated Molar Caries and Dental Sealants Among US Adolescents

ABSTRACT Objective Despite the availability of effective preventive dental services, caries prevalence remains high. In this study, we examined the relationship between untreated molar caries (UMC) on the permanent molars of adolescents and the presence of dental sealants. Methods Our study population included all adolescents aged 12–19 years and those from low‐income households. We used National Health and Nutrition Examination Survey data (2011–2016). Our outcome was UMC, and the primary exposure was the presence of at least one sealant on second molars (2M), first molars (1M), or both. We examined the association between UMC and sealant status using bivariate analyses and multivariable logistic regression models controlling for socioeconomic and other covariates. All analyses were weighted and accounted for complex survey data; p < 0.05 was considered significant. Results Among adolescents ( n = 3601), 15.3% had UMC, and 55.7% experienced caries in permanent molars. Molar sealant prevalence was 30.8%, while 12.8% and 3.8% had only 1M and 2M sealants, respectively. Adolescents without sealants had a higher prevalence of UMC than those with 1M, 2M, or both sealants (22.3% vs. 10.6%, 8.0%, and 6.2%, respectively). Adjusted models indicated that adolescents with both 1M and 2M sealants had 72% lower odds of UMC than those without sealants (OR = 0.28, 95% CI: 0.18, 0.44). Findings were similar but more pronounced for adolescents in low‐income households. Conclusions The prevalence of UMC is significantly higher among adolescents without sealants. Oral health programs should promote and prioritize sealants, especially for 2M, to improve adolescent oral health and reduce the burden of dental caries.