Sealants for preventing dental caries in primary teeth

Area of Science:

• Dentistry
• Preventive Dentistry
• Pediatric Dentistry

Background:

• Pit and fissure sealants are protective plastic materials applied to occlusal tooth surfaces to prevent dental caries.
• Deep pits and fissures are prone to retaining food debris and bacteria, increasing susceptibility to decay, especially in children and adolescents.
• While effective in permanent teeth, sealant efficacy in primary teeth remains uncertain.

Purpose of the Study:

• To evaluate the effectiveness of pit and fissure sealants in preventing caries on primary molars compared to no sealant or alternative sealants.
• To assess adverse effects and retention rates of different sealant types in primary teeth.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
• Studies compared sealants (resin-based, glass ionomer-based) with no sealant or other sealant types in children aged 18 months to 8 years.
• Data on caries development, adverse events, and sealant retention were extracted and analyzed.

Main Results:

• Nine RCTs involving 1120 children were included. Evidence for fluoride-releasing sealants showed no significant difference in caries prevention compared to no treatment.
• Glass ionomer-based sealants yielded equivocal results, with one study showing insufficient evidence of difference and another indicating a beneficial effect.
• The certainty of evidence for caries prevention was low or very low; only one study reported adverse events (gag reflex).

Conclusions:

• The current evidence base regarding pit and fissure sealants in primary teeth is limited and of low certainty.
• There is a significant evidence gap concerning the caries-preventive effects and retention of sealants in primary dentition.
• Further robust RCTs are necessary to address these evidence gaps and inform clinical practice for pediatric dental caries prevention.