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Evidence summaries

Sealants for Preventing Dental Decay

Resin based sealants are effective in preventing caries of the occlusal surfaces of permanent molars in high risk children and adolescents. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 38 studies with a total of 7924 subjects. Fifteen studies evaluated the effects of sealant compared with no sealant (n=3620 in 14 studies plus 575 tooth pairs in one study); 24 studies evaluated one type of sealant compared with another (n=4146); and three trials with evaluated glass ionomer sealant versus no sealant (905 participants). Children were aged from 5 to 16 years. Studies rarely reported the background exposure to fluoride of the participants or the baseline caries prevalence.

Resin-based sealant compared with no sealant: Compared to control without sealant, second or third or fourth generation resin-based sealants prevented caries in first permanent molars in children aged 5 to 10 years (table 1). This caries preventive effect was maintained at longer follow-up but both the quality and quantity of the evidence was reduced.

Resin-based sealant compared to control without sealant for preventing dental caries

OutcomeRelative effect (95% CI)Control teethSealed teeth (95% CI)Participants (studies)
Dentine caries in permanent molars (follow-up: 2 years)OR 0.12 (0.08 to 0.19)400 per 100063 per 1000(38 to 96)1 548 children randomised & 1322 evaluated after 2 years (6 studies)

Glass ionomer sealant compared with no sealant: was evaluated by three studies. Results at 24 months were inconclusive (very low-quality evidence).

Sealant compared with another sealant: the relative effectiveness of different types of sealants is unknown (very low-quality evidence). We included 24 trials that directly compared two different sealant materials. Comparisons varied in terms of types of sealant assessed, outcome measures chosen and duration of follow-up.

Adverse effects: Only four studies mentioned adverse effects and stated that no adverse effects were reported by participants.

References

Primary/Secondary Keywords