An Oral Health Disparity among Puerto Rican Schoolchildren

The Puerto Rico Health Reform provides coverage for pit and fissure sealants to the medically indigent population. In Puerto Rico public and private school attendance may be considered a surrogate measure for socioeconomic status.

Objectives: (1) To compare the prevalence of pit and fissure sealants in twelve year olds attending public and private schools in Puerto Rico; (2) to compare the prevalence of sealants to the results from a similar study conducted in 1997.

Methods: The presence of sealants was evaluated among schoolchildren in Puerto Rico using a probabilistic sample of 132 schools, stratified by health region and type of school (public and private). Trained and calibrated examiners used modified NIDCR diagnostic criteria and procedures to perform the visual/tactile oral examination.

Results: 1550 participants were evaluated in 132 schools in Puerto Rico; 31 in private and 101 in public schools; 47% of children were males and 53% were females. The overall prevalence of sealants on any tooth was 19.5%, with higher prevalence in private (32.1%) than in public schools (18.5%). Similarly, the prevalence of sealed first molars was higher in private schools (28.0%) compared with public schools (15.5%); with the overall prevalence of 16.4%. Overall, the prevalence of sealants increased compared to that from 1997.  In 1997, 11% of children in private schools had sealed first molars, and only 3.4% of children in public schools.

Conclusions: Health disparities between children attending public and private school persevere in Puerto Rico. The health reform in Puerto Rico appears to have improved the access to sealants in 12 year olds attending public schools.