Prevalence and socio-economic disparities in fissure sealant placement among adolescents in the Limpopo Province, South Africa.

OBJECTIVES This study investigated socio-economic factors associated with the placement of fissure sealants in a population of South African adolescents. METHOD The study participants were high school students aged 12 to layers who provided baseline data during 2005 in a tobacco-use prevention trial, and consented to oral examination (n=1103). Information was obtained using a self-administered survey questionnaire, including demographic data, data on oral health behaviour, the employment status of parents/guardians, and the family structure of the household and on health insurance enrolment. The main outcome measure was the presence of a fissure sealant on any tooth, recorded using the WHO oral examination protocol. Data were analysed using chi-square statistics and multiple logistic regression analysis (p<0.05). RESULTS Overall, only 3.5% (n=37) of the study participants had a fissure sealant, and only 31.3% (n=345) had ever made a dental visit. Those who had attended seeking mostly preventive care were significantly more likely to have a fissure sealant than those who had visited mostly when they were in pain (14.2% vs. 2.9%; p<0.001). In the multi-variable adjusted analysis, those reporting to have parents who are both employed (OR = 2.76; 2.26 - 3.38), and reporting regular preventive dental visits (OR = 3.55; 2.28 -5.58) were positively associated with receiving fissure sealant, while those who self-identified as black (OR = 0.04; 0.01 - 0.13), were significantly less likely to present with a fissure sealant as compared with other ethnicity/race groups. CONCLUSIONS Higher socio-economic status and regular access to preventive care were significantly associated with the placement of fissure sealants in the studied population.