Dental caries are the most common childhood disease in the United States. Dental sealants are materials that are applied to the pits and fissures of healthy teeth to prevent dental caries or other forms of decay. This method prevents bacteria ingress and acid dissolution and targets the portions of the tooth surface where ~90% of the decay develops. Sealants are safe and effective in preventing caries on both primary and permanent teeth (> 90% reduction in caries on the sealed surface). The application of sealants is minimally invasive, painless and is typically well-accepted by patients, and sealants reduce overall dental care costs. Two major classes of materials have been used as sealants: glass ionomers and resins based sealants. Glass ionomers release fluoride that provides some antimicrobial and re-mineralization activity; however they have a higher water uptake, poorer retention and higher micro-leakage scores. Photo-curable methacrylate-based resins have better retention but failures rates are still unacceptably high; they de-bond and chip off the tooth surface within a few years from application and don?t last through childhood. A significant increase of the sealant?s lifetime is required to make this preventive treatment more cost-effective. Premature sealant loss reduces the effectiveness of this preventive treatment and it is one of the reasons why it is underused in the U.S., where less than 50% of children receive it. It is believed that poor retention of methacrylate-based sealants is due to a combination of hydrolytic degradation of the polymer matrix and mechanical failure, especially related to fatigue under the forces of mastication. The dental profession awaits the development of a modern, more durable, resin-based sealant. This research will develop a novel polymer matrix for sealants that is characterized by excellent mechanical properties but is not physically degraded by hydrolysis in the oral environment. In Phase I we obtained proof-of-concept for the synthesis and performance of our new sealant monomer concept. In Phase II we will transition our new materials beyond this earliest stage of discovery, so that their clinical and commercial potential can be realized. Aside from improving pediatric health, the economic stakes for U.S. health services are staggering; Medicaid dental expenditures for children alone is projected to increase from $4.8 billion in 2010 to more than $12.6 billion in 2020. Since the majority of this spending is for treating caries, the development of a new class of durable, expanded lifetime dental sealant materials that provide more effective and more widely adopted prevention could significantly reduce these expenses. If sealants with an optimal retention rate are developed, the cost of this preventive treatment will be low compared to its benefit, especially considering that implementation can be carried out by adjunct dental personnel in private dental offices or off-site public health initiatives. The need for novel and improved dental sealants is therefore significant. Further, the demand for pit and fissure sealants is expected to growth by more than 7% annually, driven by increased acceptance by dentists and patients.
/ Public Health Relevance Statement Public Health Relevance Statement: New dental sealants with improved durability and greater longevity are needed. In this project we are creating, testing and validating a new type of polymer material for dental sealant formulations that will significantly improve sealant performance. Our work will positively benefit the preventative dental health of patients and will lower long-term dental healthcare costs.
