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Sealant and fluoride varnish in caries: a randomized trial
M Bravo1, J Montero, J J Bravo
1Department of Preventive and Community Dentistry, School of Dentistry, Campus de Cartuja s/n, University of Granada, E-18071 Granada, Spain. mbravo@ugr.es
Journal of Dental Research
|November 24, 2005
Summary
Dental sealants significantly reduced occlusal caries in children over nine years compared to fluoride varnish. Fluoride varnish effectiveness waned after discontinuation, highlighting sealants
Area of Science:
- Dental caries prevention
- Pediatric dentistry
- Preventive dental treatments
Background:
- The long-term effectiveness of dental sealants and fluoride varnish in preventing occlusal caries is not well-established.
- Understanding the impact of treatment discontinuation is crucial for evaluating the sustained benefits of preventive dental interventions.
Purpose of the Study:
- To compare the efficacy of dental sealants versus fluoride varnish in preventing occlusal caries in children's permanent first molars over a nine-year period.
- To assess the caries prevention effects during the active treatment phase and the subsequent discontinuation period.
Main Methods:
- A nine-year clinical trial involving three groups of schoolchildren (ages 6-8): control, dental sealant application (with reapplication up to 36 months), and fluoride varnish application (with reapplication up to 42 months).
- Inclusion criteria focused on initially healthy permanent first molars with complete occlusal eruption.
- Caries reduction was evaluated by comparing the incidence of occlusal caries across the groups at the nine-year follow-up.
Main Results:
- Dental sealants demonstrated a significant caries reduction of 65.4% compared to the control group over nine years.
- Fluoride varnish showed a caries reduction of 27.3% compared to the control group, but was not effective during the five-year discontinuation period.
- A higher percentage of molars in the sealant group remained caries-free compared to the fluoride varnish and control groups at nine years.
Conclusions:
- Dental sealants provide a more sustained and effective long-term prevention of occlusal caries in children's permanent first molars compared to fluoride varnish.
- The preventive benefits of fluoride varnish diminished significantly after its discontinuation, suggesting limited long-term protection.
- Sealants represent a superior preventive strategy for occlusal caries, offering durable protection beyond the active treatment phase.
