Preventing fissure caries by sealants and fluorides: 30-month results

Abstract

OBJECTIVES: To compare the effectiveness of using fissure sealants and topical fluorides in preventing caries in the first permanent molars. METHODS: Children studying in two primary schools in Shenzhen, China, were clinically examined. Permanent first molars with deep occlusal fissures or fissures with signs of early caries were selected and randomly allocated into one of four treatment groups: 1) a single application of a light-cured resin fissure sealant (FS), 2) a single application of a glass ionomer sealant using the atraumatic restorative treatment (ART) technique, 3) application of a 5% sodium fluoride (NaF) varnish every six months, and 4) annual application of a 38% silver diamine fluoride (SDF) solution. The treatments were provided in the two schools using hand instruments and portable equipment. All included teeth in the same side of the mouth of a child received the same treatment. Follow-up examinations at 6-month intervals were conducted by a single trained examiner using an intra-oral LED light source, disposable mouth-mirrors, and probes. Status of the sealants, present or not, and status of the molars, presence of caries into dentine or being restored, were recorded. RESULTS: A total of 423 molars in 161 children (mean age 7.9 years) were treated at baseline, and 371 molars (87.7%) were examined after 30 months. The 30-month retention (complete or partial) rates of the resin and the ART sealants were 70.6% and 60.6% respectively (Chi-square test, p>0.05). The proportion of molars which remained sound at the 30-month evaluation were 94.5% for FS, 95.4% for ART, 94.4% for SDF, and 88.9% for NaF (Chi-square test, p>0.05). CONCLUSIONS: The 30-month retention rates of the two types of sealants were similar. The effectiveness of the four methods in preventing fissure caries was also similar.