Pending Rule Change Will Allow More Children in North Carolina to Receive Sealants and Avoid Cavities

CARY— The North Carolina Oral Health Collaborative (NCOHC), a program of the Foundation for Heath Leadership & Innovation (FHLI), announced today that the North Carolina Board of Dental Examiners has unanimously voted to move for the permanent adoption of an important rule change that will open doors for access to quality preventive oral health care for North Carolina’s most vulnerable.

“The oral health needs of the state’s most disadvantaged groups are tremendous, but not insurmountable,” said Dr. Zachary Brian, NCOHC Director. “This rule change will be instrumental in improving access to critical preventive oral health care and is one step forward in addressing access disparities.”

On December 13, 2019, the North Carolina Board of Dental Examiners unanimously voted to move for permanent adoption of a change to Occupational Licensing Boards and Commissions Rule 16W. The rule change will allow dental hygienists to further practice to the full extent of their licensure by providing preventive services such as sealants and fluoride treatments in high-need settings without a dentist’s prior exam.

Before it goes into effect, the rule change, co-sponsored by the FHLI’s NCOHC and the North Carolina Dental Society (NCDS), must receive final approval from the Rules Review Commission. Approval is currently anticipated sometime in mid-January.

Tooth decay is the single most common chronic childhood disease, disproportionately affecting low-income populations. Nationwide, roughly 50 percent of children in low-income families experience tooth decay, and dental disease is responsible for a collective 51 million hours of school missed each year.

Dental Sealants: A Cost-Effective Opportunity for Preventive Oral Health Care

Cost of care is a significant barrier that prevents children and families from accessing oral health care. At one-third the cost of a cavity filling, dental sealants are a lower-cost solution that can dramatically reduce the likelihood that an individual will develop a cavity during childhood.

Unfortunately, North Carolina’s requirement that a prior exam from a dentist be completed before a dental hygienist can apply a sealant adds additional cost and delays to the process. In North Carolina, only 16 percent of children ages 6 to 9 have received a sealant on a permanent tooth.

Without the requirement for a prior exam by a dentist, dental hygienists can offer sealants in alternative settings like schools or after-school clinics rather than at a dentist’s office. School oral health programs, in particular, are very effective methods for reaching children who would otherwise not have access to preventive services from a private dentist.

According to the CDC, each tooth sealed saves more than $11 in treatment costs down the road. With just over one million low-income children in North Carolina, expanded access to dental sealants has the potential to save a tremendous amount downstream.

A dental sealant is a thin coating applied on the chewing surfaces of a child’s back teeth. The application of a sealant is a simple and painless procedure that adds an extra layer of protection to teeth which are most susceptible to decay because of the pits and grooves on their chewing surfaces. A dental sealant protects against 80 percent of cavities for two years, and 50 percent of cavities for up to four years.

Eliminating Regulatory Barriers to Increase Access to Oral Health Care in North Carolina

In 39 states across the country, dental hygienists can apply dental sealants without a prior exam or supervision from a dentist. This procedure is within the clinical training of a hygienist, but in states like North Carolina, regulatory barriers hinder access and delivery to these preventive procedures.

The rule change co-sponsored by NCOHC and NCDS would eliminate this regulatory obstacle, increasing access to preventive oral health care services for North Carolina’s most vulnerable populations.

About FHLI’s North Carolina Oral Health Collaborative

The North Carolina Oral Health Collaborative works to advance systems change, improving the overall health and well-being of all North Carolinians by increasing access and equity to oral health care. NCOHC advocates seek to influence policy at a statewide level, and through collaboration, listening, and knowledge-sharing, NCOHC  works to provide maximum impact in achieving optimal oral health care to all North Carolina communities.


For more information, contact:
Marni Schribman, Director of Communications & Public Relations
Foundation for Health Leadership & Innovation