Whether sealants are more cost-effective than restorative dentistry in reaching dental health goals for patients of private practitioners will depend on the relative excellence of materials and techniques, and on the values of prevention per se held by practitioner and patient. Given this heavy dose of subjectivity in the equation, it is doubtful if experimental cost-effectiveness studies of sealants in private practice will be fruitful. A more likely approach to answering questions on cost-effectiveness would be empirical testing of sealant reimbursement in prepayment programs under the standards suggested.