Attitudes toward and use of pit and fissure sealants

The results indicate that attitudes toward and use of sealants are generally low. There are, however, some dentists who use sealants proportionately more than other dentists, these being less recent graduates, dentists who practice in the northeast, and those dentists who are oriented generally more toward preventive procedures. The reasons selected by dentists for not using pit-and-fissure sealants were surprising. Despite considerable published evidence to the contrary and the provisional acceptance of two by the American Dental Association, Council on Dental Materials and Devices, most dentists are not yet convinced of the effectiveness of the procedure in preventing caries. In addition, many dentists were concerned that the material did not last long in the mouth, although high retention rates for periods in excess of one to three years had been reported. Also, a great concern for the possible sealing in of decay seems unsubstantiated by either clinical experience or reports from studies designed to monitor the activity of bacteria sealed in pits and fissures of teeth. Conversely, dentists infrequently selected either the cost of equipment and material or the time required for the procedure as reasons for not using pit-and-fissure sealants. The demanding technical requirements for proper application of the sealant, however, especially the avoidance of any moisture contamination, does require skilled personnel and substantial chair time. These factors are important considerations in the determination of the cost-effectiveness of this procedure in comparison to other preventive procedures for pit-and-fissure caries. These inconsistencies indicate a problem in the transmission of knowledge regarding sealants. Increased use of sealants, then, seems to be dependent on improving communication regarding their function and value to the dental profession. Data on the effectiveness of sealants over periods of three or more years have recently been reported and additional evaluations of this procedure are being reported. It would be expected that reports published since this research during the winter of 1974 will have an effect on both attitudes toward and use of sealants.