Knowledge and practice of pit and fissure sealants: A comparative study of both students and teachers in two schools

Pit and fissure sealant is an effective caries preventive measure, yet their global utilization in dental practice remains low. Limited knowledge of updated guidelines and technical advances, along with insufficient sealant education may contribute to this issue. This study explored the knowledge and practice of students and teachers regarding sealant use at two schools.

This cross-sectional survey invited participants from West China School of Stomatology (WCSS) and Academic Centre for Dentistry Amsterdam (ACTA) to complete a questionnaire either on site or electronically. The questionnaire covered awareness of national guidelines, clinical experience, decision-making and sealant application procedures. Data were analyzed using Chi-squared or Fisher's exact tests. Statistical significance was set at P < 0.05 and multiple comparisons were adjusted using the Bonferroni correction.

A total of 85 students and 25 teachers from WCSS, along with 87 students and 30 teachers from ACTA, completed the questionnaire. Over 60% of the participants reported familiarity with the national sealant guideline or advisory, with no significant differences in awareness between teachers and students within the same school or between the two schools. For clinical decision-making, most participants from both schools (> 80%) considered caries risk in sealant application decisions. ACTA participants consider sealant application until later stage of caries (Sound-Enamel cavitied lesions), whereas WCSS participants favored applying sealants at earlier stages (Sound-Opaque). Differences of clinical procedures were also detected between schools. Abrasive paste was preferred by ACTA participants, while toothpaste was chosen by more WCSS teachers and students (P < 0.001). WCSS respondents used cotton rolls for saliva control, while ACTA participants preferred rubber dam isolation (P < 0.001). Fewer WCSS students considered glass ionomer cement as the sealing materials compared to their teachers (P < 0.001) and the ACTA students (P = 0.005).

This cross-section survey study revealed that in both schools, teachers and students successfully integrated caries risk into sealant decision-making. Agreement on the overall principles of sealant placement was observed; however, some discrepancies were identified in specific indications and procedural details. These observed differences suggest a need for further alignment of sealant guidelines and the operational reginal standards of detailed clinical procedures.