Statistical model for assessing the impact of targeted, school-based dental sealant programs on sealant prevalence among third graders in Ohio.

Abstract

Since Ohio school-based dental sealant programs target economically disadvantaged groups, simple comparison of sealant prevalence between schools with sealant programs and those without is problematic due to underlying disparities between the two in sealant prevalence. The goal of our analysis was to estimate the impact of sealant programs on sealant prevalence among third graders in Ohio by applying a statistical model to data from a 1998-99 Ohio oral health screening survey of schoolchildren to control for differences in background characteristics. Included in the analysis were 9,747 third graders at randomly selected schools in Ohio. Chi-square statistics and survey logistic regression were used to analyze the association of sealant presence with school sealant program participation, dental care payment method, sex, race, and school lunch program eligibility. The unadjusted odds ratio for dental sealant presence was 3.4 (95% confidence interval [CI]=2.6, 4.4; P<.01). Adjusting for race and income, the odds of having dental sealants among children in schools with dental sealant programs increased to 4.8 (95% CI=3.5, 6.5; P<.01). Not controlling for confounders can result in underestimation of the impact of targeted school sealant programs.