Evaluation of a fissure sealing programme in a Danish Public Child Dental Service

Most studies on fissure sealants have been conducted as explanatory trials. The present study takes a pragmatic approach to the use of fissure sealing as a caries-preventive measure. The study was conducted in two municipalities in the Copenhagen area, one (S) with a policy of sealing all occlusal fissures of first permanent molars and another (C) where fissure sealing was not used. The study included all the 1053 12-year-old children in the two municipalities who had participated in the dental service since preschool age. Fissure sealing with Delton(R) was performed as soon after eruption as possible. Out of 2180 first permanent molars in S, 1721 (79 per cent) were sealed. An overall complete retention rate of 40 per cent was obtained after the 6- to 7-year observation period. The caries prevalence on all types of surfaces not sealed was almost identical in both municipalities, supporting the assumption that they had similar caries levels. On the target surfaces the mean caries increment for girls was 1.4 and for boys 1.2 in S compared with 2.0 (girls) and 1.6 (boys) in C, giving an effectiveness in caries reduction of 32 and 25 per cent for girls and boys respectively. For girls, 5 occlusal surfaces had to be sealed in order to save one filling; compared to 8 surfaces for boys.