Dental sealants and flowable composite restorations and psychosocial, neuropsychological, and physical development in children
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Updated: May 1, 2026

Evaluating the Effects of Different Polishing Methods on Color Stability of Dental Restorations in Pediatric Dentistry
Published on: June 6, 2025
Nancy N Maserejian1, Peter Shrader2, Felicia L Trachtenberg3
1Senior research scientist and an associate director, Department of Epidemiology, New England Research Institutes, Watertown, and Lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Mass., USA. nmaserej@post.harvard.edu.
Purpose:
Dental sealant materials may intraorally release their components, including bisphenol-A (BPA), but long-term health effects are uncertain. The New England Children's Amalgam Trial (NECAT) found that composite restorations were associated with psychosocial, but not neuropsychological or physical, outcomes. The previous analysis did not consider sealants and preventive resin restorations (PRRs), which were routinely placed. The purpose of this analysis was to examine sealant/PRR exposure in association with psychosocial and other health outcomes.
Methods:
NECAT recruited 534 six- to 10-year-olds and provided dental care during a five-year follow-up. Annually, examiners conducted psychosocial and neuropsychological tests and measured body mass index (BMI) and fat percentage (BF%). Associations between surface years (SY) of sealants/PRRs and outcomes were tested using multivariable models.
Results:
Cumulative exposure level to sealants and/or PRRs was not associated with psychosocial assessments (eg, total problems: Child Behavior Checklist, 10-SY β=-0.2 ± 0.3, P=.60) or neuropsychological tests (eg, full-scale IQ, 10-SY β=0.1 ± 0.2, P=.60). There were no associations for changes in BMI-for-age z-score (P=.40), BF% (girls 10-SY β=-0.2 ± 0.3; boys 10-SY β=-0.1 ± 0.3), or menarche (10-SY hazard ratio=0.91, 95% confidence interval=0.83-1.01, P=.08).
Conclusions:
This study showed no associations between exposure level of dental sealants or PRRs and behavioral, neuropsychological, or physical development in children over 5-years.
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