Trial shows caries reductions at one year in school-based sealant programme

Area of Science:

• Pediatric Dentistry
• Public Health Dentistry
• Cariology

Background:

• Dental caries remains a significant public health issue, particularly in low-income populations.
• Early intervention strategies, such as dental sealants, are crucial for preventing caries in children.
• School-based programs offer a practical setting for delivering preventive dental care.

Purpose of the Study:

• To evaluate the one-year effectiveness of dental sealants in preventing new carious lesions in first molar teeth.
• To assess the influence of baseline caries risk factors (Streptococcus mutans and Lactobacillus counts) on sealant efficacy.
• To determine sealant retention rates in a school-based setting.

Main Methods:

• A pragmatic split-mouth randomized controlled trial was conducted.
• Children from low-income backgrounds received sealants on one of each first molar pair.
• Clinical examinations and caries risk assessments (including Streptococcus mutans counts) were performed at baseline and one year.

Main Results:

• Sealed molars showed a significantly lower risk of developing new carious lesions compared to control molars (OR = 0.26).
• Sealant effectiveness was particularly pronounced in children with active caries or high Streptococcus mutans counts at baseline.
• Overall sealant retention was 52.7%, with lower retention observed in the maxilla compared to the mandible.

Conclusions:

• The school-based dental sealant program demonstrated significant effectiveness in reducing caries incidence in one year within low-income communities.
• Individualized selection of schoolchildren based on caries risk factors can enhance the efficacy of school-based preventive programs.
• Further research into optimizing sealant retention, especially in the maxilla, is warranted.