Fifteen years after dentists began sealing children's teeth with plastic to ward off decay, most children still do not get the treatment, researchers say - and the result is a high rate of preventable cavities among teenagers.

A survey of U.S. dental health found that only 33 percent of 12- to 17-year-olds were free of cavities, government scientists said this week.Although twice as many youngsters get dental sealants now than did 10 years ago, sealant use was still only 19 percent in children and adolescents and was particularly low among blacks and Hispanics.

"The oral health of Americans has improved substantially over the last couple of decades, but the survey points to some challenges we have to address," said Dr. Jack Brown of the National Institute of Dental Health.

The institute released results of surveys carried out between 1988 and 1994 as part of the National Health and Nutrition Examination Survey - abbreviated as NHANES III - by the National Center for Health Statistics.

Setting up mobile dental offices in parking lots and shopping malls across the country, the researchers looked at thousands of sets of teeth in people from infancy to old age. Brown said the survey provides the most reliable estimates yet of dental disease in several population subgroups, including blacks, Mexican-Americans and people over 60.

Reflecting a movement to more aggressive preventive care, including the use of sealants and fluoride, the study showed no cavities in 55 percent of children and adolescents aged 5 to 17. That leaves 45 percent - millions of children - who still have tooth decay.

Of the trend, Brown said, "We can trace this decline back to at least 1971-74. There has been a doubling of the percentage of children" who have not had cavities, he said.

It is believed that sealants have a lot to do with this trend, added Brown. Dentists apply the plastic coatings to the most decay-prone teeth, which are the back teeth, or molars, whose surfaces have many grooves and fissures that trap bacteria and food, leading to decay. The sealants last several years.

Dr. John Ficarelli, a pediatric dentist who practices near Boston, said most of his patients get sealants at age 6 and again at 12. But the cost of $25 to $50 per tooth is a barrier to some families, he said. Moreover, not all dentists routinely apply sealants, particularly dentists who do not specialize in treating children.

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The notion that cavities are largely a thing of the past is untrue, Ficarelli said. "I see it every day," he said in an interview. "I saw six new patients today, and three of them had significant decay. One of them was only 28 months old."

The stubborn problem of tooth decay in adolescents would respond to greater use of sealants, said Ficarelli, but it's also partly a result of behavior. "Many college-aged kids or young adults leave my practice their freshman year and then get out of the habit of regular visits," he said, adding that it is an age when young people are leaving home and the presumably more healthful diets their parents enforced.

Overall, however, more aggressive preventive and restorative dentistry is enabling Americans to keep their their teeth longer: Only 10 percent of people aged 18 through 74 were totally toothless, compared with nearly 15 percent in a survey carried out from 1971 to 1974. The remaining 90 percent have 23.5 teeth, on average: Nearly one-third of adults had kept all 28 teeth (not including wisdom teeth).

Not that they couldn't use some work, though. More than 40 percent of all adults who had teeth - nearly 62 million Americans - had at least one tooth or tooth space that needed treatment, from missing or bad fillings, crowns and bridges, recurring decay or other problems.

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