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.