Issues in the widespread adoption of pit-and-fissure sealants.

Seven issues affecting the use of sealants have been discussed, and five strategies have been suggested to promote their wider use in private and public settings. A strong initiative by industry, in conjunction with organized dentistry and government, is needed to generate public demand and to promote appropriate use by practitioners and auxiliaries. The most fruitful market for sealants at present and in the future may be through public health programs using dental auxiliaries, because the primary prevention of dental caries is stressed more in this area, whereas private practitioners tend to focus more on treating caries. During these times of financial restriction, there is all the more reason to focus effective caries prevention on those tooth surfaces that develop more than half of all carious lesions. The most efficient use of the limited private and public funds that are available to promote oral health must be made. Given the new sealant materials available and the opportunity to delegate their application to auxiliary personnel in both private and public practice, the challenge now is to promote the widespread use of this technology in conjunction with appropriate fluorides so that no child is denied the opportunity to enjoy a caries-free dentition.