OBJECTIVE To assess the extent to which Ohio dentists report using pit and fissure sealants and factors associated with sealant use. METHODS A mail survey of a random sample of Ohio dentists was conducted in 1989 and repeated in 1992 with a newly drawn sample. Only responses from general dentists were analyzed using univariate analyses and multiple regression. RESULTS Dentists who reported using sealants increased from 79.4 percent in 1989 to 91.8 percent in 1992. In 1992, 42.9 percent were low-level users (< 15% of school-aged patients), 41.7 percent were moderate-level users (15-39%), and 15.3 percent were high-level users (> 39%). Over three-fourths of sealant-using dentists expressed some degree of willingness to seal incipient caries. The level of sealant use was associated with dentists' knowledge about sealants, conservative management of dental caries, number of children seen in the practice, and influence of insurance coverage for sealants. The regression model explained 22.0 percent of the variance. Clinical factors associated with the level of use were: dentists' willingness to seal premolars; caries-free teeth; teeth with deep, narrow pits and fissures; teeth with small, frank occlusal caries; and patients 18 years of age or older. This regression model explained only 15.1 percent of the variance. CONCLUSIONS The grate majority of Ohio dentists report using sealants. The percent of reported sealant users increased between 1989 and 1992. Ohio dentists are not consistent with regard to the percent of their child patients for whom they apply sealants or their willingness to seal incipient caries. Dentists continue to identify lack of insurance coverage for sealant application as a major barrier to patients receiving the service.