General dental practitioners diagnostic and treatment decisions related tofissure sealed surfaces

Objectives: The purpose of this in-vitro study was to assess the validity a nd reproducibility of the diagnosis and treatment planned for occlusal surf aces prior to and following the placement of a clear sealant by a sample of general dental practitioners (GDPs). Methods: 160 permanent posterior teeth were examined by 25 GDPs. The GDPs w ere not given any criteria and were therefore free to diagnose and plan car e, as they felt appropriate. Each GDP conducted four examinations, two prio r to and two after sealing. The teeth were serially sectioned to provide th e validating criterion. Results: After sealant placement, there was a statistically significant inc rease in specificity and decrease in sensitivity of both diagnostic and tre atment decisions. The reproducibility expressed by the kappa-statistic was of the order of 0.5 prior to and after sealing with regard to diagnostic de cisions. There was a general tendency to diagnose less disease after placem ent of a sealant (P < 0.001). There was also significantly less care (preve ntive or restorative) planned after sealant placement (P < 0.001). Conclusions: The placement of a sealant resulted in the diagnosis of less d isease and less restorative treatment. This may be appropriate as evidence exists to support the use of sealants as caries therapeutic agents. (C) 200 0 Elsevier Science Ltd. All rights reserved.