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Global knowledge, attitudes, and practices toward pit-and-fissure sealants: A systematic review, meta-analysis, and
Devshri Vaja1, Abhisek Bhattacharjee1, Rajeev Kumar Singh1
1Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, King George's Medical University, Lucknow, India.
Background:
The authors aimed to synthesize global evidence on the knowledge, attitudes, and practices of dental care professionals regarding pit-and-fissure sealants, a proven preventive intervention, and to identify factors contributing to persistent evidence to practice gaps.
Types Of Studies Reviewed:
Cross-sectional studies assessing knowledge, attitudes, or practices toward pit-and-fissure sealants (PFSs) among dentists were eligible. Studies were identified through systematic database searching and screened using predefined inclusion criteria following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results:
The pooled mean knowledge score across 6 studies was 6.44 (95% CI, 4.21 to 8.66; prediction interval [PI], 0.60 to 12.28; I2 = 99.3%) and the pooled mean attitude score was 5.84 (95% CI, 4.03 to 7.64; PI, 1.13 to 10.54; I2 = 99.3%). Knowledge-related proportions were high, including knowing how to use PFSs (0.75) and performing caries risk assessment (0.75). Attitudes varied widely (eg, the belief that PFSs prevent caries: 0.69; PI, 0.08-1.00). Practice behaviors were inconsistent, with routine sealant use at 0.55 and resin sealant use at 0.70. Heterogeneity was substantial across outcomes. Results of meta-regression analyses showed region, income level, questionnaire validation, and dental care specialist proportion were important moderators in univariable models.
Conclusions And Practical Implications:
Addressing gaps in training, guideline dissemination, and system-level support is critical for improving the global integration of evidence-based sealant practices. The study protocol was registered at PROSPERO. The registration number is CRD42024558203.