The slowness in the adoption of sealant use has been caused by many interrelated professional, scientific, social, and economic factors. To study these factors, data were collected by the use of mail questionnaires sent to a representative sample of 3,504 private practice general dentists. The average percent of patients 18 years of age and younger receiving sealants was 18.7. Nearly one-third of the respondents indicated that none of their patients received sealants. Data describing the following factors were obtained: demographic background, sealant awareness, attitudes and knowledge about sealants, and decision-making factors. We concluded that professional organizations should take a more active role in promoting sealants to dentists, professional organizations and governmental agencies should increase efforts to inform patients/consumers of the benefits of sealants, guidelines for sealant use should be developed, state boards should permit the delegation of sealants to trained auxiliaries, and sealant manufacturers should make more effort to advertise and promote sealants.