Socioeconomic Inequalities in the Prevalence of Pit and Fissure Sealant Use Among Mexican Adolescents Aged 12 and 15: Implications for Public Policy.

Background Oral diseases are a public health problem due to their high global prevalence and incidence and their significant health and economic burden. Despite being preventable, dental caries remains the most common chronic disease affecting children and adolescents globally. Caries prevention relies on multifaceted strategies, and pit and fissure sealants (PFS) are a cost-effective intervention, physically preventing biofilm accumulation on occlusal surfaces and thereby reducing caries. The objective of this study was to determine the existence of socioeconomic inequalities in the prevalence of pit and fissure sealant (PFS) use in Mexican adolescents aged 12 and 15 years. Materials and methods An observational, cross-sectional study was conducted in 1,538 Mexican adolescents aged 12 and 15 years. The presence of pit and fissure sealants was determined through a clinical examination and served as the dependent variable. This was dichotomized as follows: 0 = no presence of PFS and 1 = with at least one PFS. A questionnaire was administered to determine a series of independent sociodemographic variables and socioeconomic position (SEP) indicators. Statistical analysis was performed using Fisher's exact test, the chi-square test, and a non-parametric test for trend in Stata 14.0 (StataCorp LLC, College Station, TX). Results By age group, the highest percentage was found to be 15 years old (55.3%, n=850). Regarding sex, 50.1% (n=770) were boys. The prevalence of having any tooth with PFS was 1.3% (n=20). An association was observed between the prevalence of PFS and the SEP variables of education (p=0.047) and occupation (p=0.017). It was also observed that as the socioeconomic status (SES) tertiles increased (from the poorest to the richest), the prevalence of PFS also increased (p<0.05). Similarly, the prevalence of PFS was higher among those who did not always live in the community where they currently resided (2.3%, n=10 versus 0.9%, n=10; p=0.035) and in those who regularly visited the dentist (3.9%, n=9 versus 0.8%, n=11; p=0.001). Conclusions A very low prevalence of PFS use (1.3%, n=20) was observed in this sample of Mexican adolescents. The results suggest the existence of socioeconomic inequalities in the use of PFS and a low level of dental prevention behavior. The data show a clear trend where the use of PFS is much higher among teenagers from wealthier backgrounds compared to those from poorer backgrounds, and this pattern is seen in both education and job-related measures of socioeconomic status. It is necessary to implement PFS placement programs if oral health is to be improved.