[Inter-dentist variability in the provision of fissure sealants]

It has been recognized that the diagnosis and treatment of caries vary so widely among dentists that patients increasingly feel the need to inform themselves and to compare recommended treatments before accepting one. This phenomenon is all the more present in pit and fissure surfaces intervention choices, where there is a wide variety of available treatments. This article will attempt to highlight the factors explaining the pit and fissure treatment variation. The lack of knowledge on pit and fissure sealant effectiveness and indications as well as dentists' clinical experiences have given rise to different myths and prejudices that have had an impact on the variability of treatment decision making. When in doubt about the necessity to execute a treatment, each decision to withhold treatment results in an incomplete care episode. A dentist's lack of comfort with withholding treatment may stop him from offering preventive care and cause him to follow a restoration-oriented practice. It is therefore increasingly urgent to achieve agreement among dentists, especially as current knowledge on the subject is giving way to new research.