This paper reviews the literature relating to the economic evaluation of sealants. Economic issues are commonly cited for lack of sealant utilization, although there are no adequate economic analyses on which to base this belief. The design of much of the existing economic literature regarding sealants is inappropriate, for example many analyses do not consider the advantages of a sound tooth in the calculation of budget. In general the recent literature supports the efficiency and the effectiveness of sealants. However, there is a need for well designed studies, examining modern materials and populations with current caries prevalence. In particular there is a need for well conducted cost-benefit analyses and cost-utility analyses, which should encompass discounting for time and sensitivity analyses. Results from such research would assist clinicians and policy makers alike, in decisions regarding the provision of care with regard to sealant provision at the individual and community level.