Practitioner acceptance of pit and fissure sealants has been slow. To assess the factors that relate to the dentist's decision to use or not to use sealants, a comprehensive survey of 3,504 general dentists and 591 pediatric dentists was undertaken. Response rate to the mailed questionnaire was 37.6 percent (n = 1,193) for general dentists and 61.2 percent (n = 329) for pediatric dentists. Items were grouped into ten scales believed to portray major variables associated with level of sealant use. Level of use, measured as an estimated percent of child patients receiving sealants, served as the dependent variable. A stepwise multiple regression was used to study the relationship between the scales and estimated level of use. Overall, the preventive orientation, opinion, and patient influence scales contributed the most to the explanation of the estimated level of use. These scales, for both general dentists and pediatric dentists, had the strongest simple correlations with sealant use and they also were the three scales that showed up most consistently as the prime scales in the multiple regression analyses. These results suggested that efforts aimed at encouraging a preventive philosophy and improving patient and practitioner opinion and knowledge about sealants should be undertaken.