A LONGITUDINAL EVALUATION OF FISSURE SEALANTS APPLIED IN DENTAL PRACTICES

Sealants are highly effective in preventing dental caries in the pits and fissures of teeth when applied by trained operators in clinical tr ials and public health programs. The effectiveness of fissure sealants when applied in dental practices is still not known. The purpose of t his longitudinal study was to evaluate the effectiveness of fissure se alants applied in dental practices in preventing dental caries on occl usal surfaces of first permanent molars. In 1990, on the Island of Mon treal, 911 randomly selected children, from 6 to 9 years of age, were examined; out of those, 816 and 733 were re-examined in 1991 and 1992, respectively. Only the 733 children with complete examination records were included in this evaluation. Sealant applications were either pe rsonally paid for or were paid for by private dental insurers. AU chil dren were covered for diagnosis and restorative care by a publicly fin anced and universal insurance program. Dental treatment records were p rovided by Quebec's health insurance board. In the epidemiological exa mination, the occlusal surfaces of first permanent molars, which are t he only surfaces included in this analysis, were classified into: soun d, non-cavitated and cavitated status, restored, and sealed. Sealants were evaluated for full or partial coverage of the occlusal surface an d presence of dental caries. During the first and second years, 11.6% and 17.5% of the students had new sealants. The number of new sealants placed during the two years was 507. Children with caries-free status and whose parents had high school education or higher were significan tly more likely to receive sealants during the study. Of the sealants found in 1990, 73.5% were still fully sealed after two years. Compared with sound first permanent molars in 1990, fully sealed first permane nt molars had 75% lower incidence of new restorations. This pragmatic evaluation of sealants shows that even when applied in dental practice s under uncontrolled conditions, they were effective in preventing den tal caries over a two-year period.