Despite the availability of highly effective measures for primary prevention, dental caries (tooth decay) remains one of the most common childhood chronic diseases. When properly placed, dental sealants are almost 100% effective in preventing caries on the chewing surfaces of first and second permanent molarteeth. However, sealants remain underused, particularly among children from low-income families and from racial/ethnic minority groups. Schools traditionally have been a setting for both dental disease prevention programs and for oral health status assessment. To determine the prevalence of dental sealant use among third grade students from schools with and without sealant programs, during the 1998-99 school year, the Ohio Department of Health conducted an oral health survey among schoolchildren. This report summarizes the results of this survey, which indicate that targeted, school-based dental sealant programs can substantially increase prevalence of dental sealants. Providing sealant programs in all eligible, high-risk schools could reduce or eliminate racial and economic disparities in the prevalence of dental sealants.