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The Effectiveness of Sealants in Managing Caries Lesions

¹ Centers for Disease Control and Prevention/Division of Oral Health/Surveillance, Investigations, and Research Branch, 4770 Buford Highway, MSF10, Chamblee, GA 30341, USA;
² Wallace H. Coulter School of Biomedical Engineering, 2101 Whitaker Building, 313 Ferst Dr., Georgia Tech, Atlanta, GA 30332-0535, USA;
³ School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA;
⁴ Dental Health Services Research Unit, Dundee DD24BF, Scotland, UK;
⁵ Oral Health Research Institute, Indiana University School of Dentistry, 415 Lansing Street, Indianapolis, IN 46202, USA;
⁶ American Dental Association, 211 E. Chicago Ave., Chicago, IL 60611, USA;
⁷ Department of Health Policy and Administration, The University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC 27599-7411, USA; and
⁸ Center to Address Disparities in Children’s Oral Health, University of California. San Francisco School of Dentistry, 3333 California Street, Suite 495, San Francisco, CA 94143-1361, USA

^* corresponding author, sig1{at}cdc.gov

A barrier to providing sealants is concern about inadvertently sealing over caries. This meta-analysis examined the effectiveness of sealants in preventing caries progression. We searched electronic databases for comparative studies examining caries progression in sealed permanent teeth. We used a random-effects model to estimate percentage reduction in the probability of caries progression in sealed vs. unsealed carious teeth. Six studies, including 4 randomized-controlled trials (RCT) judged to be of fair quality, were included in the analysis (384 persons, 840 teeth, and 1090 surfaces). The median annual percentage of non-cavitated lesions progressing was 2.6% for sealed and 12.6% for unsealed carious teeth. The summary prevented fraction for RCT was 71.3% (95%CI: 52.8%–82.5, no heterogeneity) up to 5 years after placement. Despite variation among studies in design and conduct, sensitivity analysis found the effect to be consistent in size and direction. Sealing non-cavitated caries in permanent teeth is effective in reducing caries progression.

KEY WORDS: pit and fissure sealants • caries

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