08 January 2019

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Sealents: yes or no? The conclusions from the American Association of Pediatric Dentistry

Massimo Gagliani

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INTRODUCTION 

Although caries prevalence is drastically decreasing in industrialized countries, the presence of carious lesions in children under twelve is still high and causes an economic burden on families and institutions that is still relevant. It has long been known that a preventive methodology for reducing the incidence of caries lesions on permanent teeth is represented by the use of sealants, composed either of resinous material or of glass ionomer cements, reinforced or not with resins.

MATERIALS AND METHODS
The American Association of Pediatric Dentistry has published a systematic review that analyzes the potential benefits of sealants in the infant population. The selected studies, whose scientific quality was found to be medium-high, compared groups of patients who had been treated with sealants  to patients groups on whom this treatment had not been performed. In another section of the study, they compared patients groups treated with sealants to groups on whom fluorinated paints were used. Finally, the studies were subdivided in relation to the observation period: studies in which the checks were performed after 3 years and studies in which these checks were completed in a period equal to or greater than seven years. 

RESULTS
The results showed that the use of sealants reduces the caries risk by 76%. In longer-term studies the gap appeared even more pronounced, with the risk of caries incidence accounting for 79% and 85% in studies with a control program over seven years. Where fluorescent paints were used, the result was also favorable for the groups of patients treated with sealants with a favorable percentage of 73% and 81% depending on whether the short or medium term was evaluated.
A lower result was observed in studies where glass ionomeric based sealants were used, which yielded favorable results just under 30% of short-term cases and about 63% in medium-term controls.

CONCLUSIONS
The use of sealants in young patients is a very effective preventive measure for the reduction of caries on permanent teeth. In fact,  the incidence of caries in patients who were treated with sealants is equal to 29% while in untreated patients it exceeds the 70%. 

For additional information:
Sealants for preventing and arresting pit-and-fissure occlusal caries in primary and permanent molars. JADA