Cited by 391Dental Health and Care UtilizationDental materials and restorationsEndodontics and Root Canal Treatments

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Pit and fissure sealants for preventing dental decay in permanent teeth

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Ahovuo-Saloranta, Anneli, Forss, Helena, Walsh, Tanya, Nordblad, Anne, Mäkelä, Marjukka, Worthington, Helen V·2017·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd001830.pub5PMC PMC6483295

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Abstract

BACKGROUND: Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria growth that can lead to dental decay. Evidence suggests that fissure sealants are effective in preventing caries in children and adolescents compared to no sealants. Effectiveness may, however, be related to caries incidence level of the population. This is an update of a review published in 2004, 2008 and 2013. OBJECTIVES: To compare the effects of different types of fissure sealants in preventing caries in occlusal surfaces of permanent teeth in children and adolescents. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched: Cochrane Oral Health's Trials Register (to 3 August 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 7), MEDLINE Ovid (1946 to 3 August 2016), and Embase Ovid (1980 to 3 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 3 August 2016. No restrictions were placed on language or date of publication. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing sealants with no sealant or a different type of sealant material for preventing caries of occlusal surfaces of premolar or molar teeth in children and adolescents aged up to 20 years. Studies required at least 12 months follow-up. We excluded studies that compared compomers to resins/composites. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results, extracted data and assessed risk of bias of included studies. We presented outcomes for caries or no caries on occlusal surfaces of permanent molar teeth as odds ratio (OR) or risk ratio (RR). We used mean difference (MD) for mean caries increment. All measures were presented with 95% confidence intervals (CI). We conducted meta-analyses using a random-effects model for comparisons where there were more than three trials; otherwise we used the fixed-effect model. We used GRADE methods to assess evidence quality. MAIN RESULTS: We included 38 trials that involved a total of 7924 children; seven trials were new for this update (1693 participants). Fifteen trials evaluated the effects of resin-based sealant versus no sealant (3620 participants in 14 studies plus 575 tooth pairs in one study); three trials with evaluated glass ionomer sealant versus no sealant (905 participants); and 24 trials evaluated one type of sealant versus another (4146 participants). Children were aged from 5 to 16 years. Trials rarely reported background exposure to fluoride of trial participants or baseline caries prevalence. Resin-based sealant versus no sealant: second-, third- and fourth-generation resin-based sealants prevented caries in first permanent molars in children aged 5 to 10 years (at 24 months follow-up: OR 0.12, 95% CI 0.08 to 0.19, 7 trials (5 published in the 1970s; 2 in the 2010s), 1548 children randomised, 1322 children evaluated; moderate-quality evidence). If we were to assume that 16% of the control tooth surfaces were decayed during 24 months of follow-up (160 carious teeth per 1000), then applying a resin-based sealant would reduce the proportion of carious surfaces to 5.2% (95% CI 3.13% to 7.37%). Similarly, assuming that 40% of control tooth surfaces were decayed (400 carious teeth per 1000), then applying a resin-based sealant would reduce the proportion of carious surfaces to 6.25% (95% CI 3.84% to 9.63%). If 70% of control tooth surfaces were decayed, there would be 19% decayed surfaces in the sealant group (95% CI 12.3% to 27.2%). This caries-preventive effect was maintained at longer follow-up but evidence quality and quantity was reduced (e.g. at 48 to 54 months of follow-up: OR 0.21, 95% CI 0.16 to 0.28, 4 trials, 482 children evaluated; RR 0.24, 95% CI 0.12 to 0.45, 203 children evaluated). Although studies were generally well conducted, we assessed blinding of outcome assessment for caries at high risk of bias for all trials (blinding of outcome assessment is not possible in sealant studies because outcome assessors can see and identify sealant). Glass ionomer sealant versus no sealant: was evaluated by three studies. Results at 24 months were inconclusive (very low-quality evidence). One sealant versus another sealant: the relative effectiveness of different types of sealants is unknown (very low-quality evidence). We included 24 trials that directly compared two different sealant materials. Comparisons varied in terms of types of sealant assessed, outcome measures chosen and duration of follow-up. Adverse events: only four trials assessed adverse events. No adverse events were reported. AUTHORS' CONCLUSIONS: Resin-based sealants applied on occlusal surfaces of permanent molars are effective for preventing caries in children and adolescents. Our review found moderate-quality evidence that resin-ba

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Wierichs, R. J., Müller, T., Campus, G., Carvalho, T. S., & Niemeyer, S. H. (2022) · Scientific Reports · doi:10.1038/s41598-022-22132-0 · Cited by 5
Survival Analysis of Glass Ionomer Cement and Resin-Based Sealant Retention: A 10-Year Follow-Up Study
Petrauskienė, S., Saldūnaitė-Mikučionienė, K., & Narbutaité, J. (2024) · Medicina · doi:10.3390/medicina60050756 · Cited by 5
Efficiency of glass ionomer sealant application in reducing hypersensitivity in MIH-molars in schoolchildren immediately and after 12 weeks
Karim, R., Baider, M., Splieth, C. H., & Schmoeckel, J. (2025) · European Archives of Paediatric Dentistry · doi:10.1007/s40368-024-00988-2 · Cited by 5
Comparison of retention rates of silver nanoparticles-based fissure sealant and conventional resin-based sealant: a one-year randomized clinical trial
Svetha, S., Bansal, K., Mathur, V. P., Tewari, N., Morankar, R., & Kalaivani, M. (2025) · European Archives of Paediatric Dentistry · doi:10.1007/s40368-025-01014-9 · Cited by 5
COVID-19 and Its Aftermath on Pediatric Oral Health: A Study of Dental Caries and Hygiene in Romanian Children
Ilea, M., Petrescu, N. B., Mirică, I.-C., Ormenișan, A., Üçtaşlı, M. B., Melnic, A., Forray, A. I., & LUCACIU, O. P. (2025) · Children · doi:10.3390/children12081061 · Cited by 6
Untitled work
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The effect of sodium hypochlorite enamel pretreatment on the shear bond strength of fissure sealant using a resin-modified glass ionomer cement and a fluoride-releasing self-etch resin adhesive
Mohammadi, N., Karimkhani, A., Bagheri, R., & Manton, D. J. (2021) · Dental Research Journal · doi:10.4103/1735-3327.311420 · Cited by 5
Cost‐effectiveness analysis of fissure sealants for caries prevention in children
Eğil, E., & Yaylalı, E. (2022) · Journal of Public Health Dentistry · doi:10.1111/jphd.12549 · Cited by 5
Parental Knowledge, Attitude and Practices Toward Dental Sealants as Preventive Strategy for Dental Caries in Children: A Cross Sectional Study
Iftikhar, A., Lal, A., Imran, A., Wasif, M., Ahmed, N., & Heboyan, A. G. (2023) · Global Pediatric Health · doi:10.1177/2333794x231214090 · Cited by 5
Research interest on dental sealant in dentistry based on the 100 most cited articles: bibliometric analysis
Simões, M. S. D. S., Rocha, A. D. O., Zendron, M. P., Santos, P. S., Bolan, M., Santana, C. M., & Cardoso, M. (2024) · Brazilian Oral Research · doi:10.1590/1807-3107bor-2024.vol38.0044 · Cited by 5
The effectiveness of completely and incompletely sealed first permanent molars on caries prevention
Ostrc, L. L., Suklan, J., & Pavlič, A. (2020) · Clinical and Experimental Dental Research · doi:10.1002/cre2.280 · Cited by 5
Majority of New Onset of Dental Caries Occurred from Caries-Free Students: A Longitudinal Study in Primary School Students
Kusama, T., Todoriki, H., Osaka, K., & Aida, J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17228476 · Cited by 7
Socioeconomic and intraoral polarization of untreated caries and tooth loss among male adolescents
Stona, P., Kramer, P. F., Vargas‐Ferreira, F., de Amorim, L. M., Coelho, E. M. R. D. B., & Feldens, C. A. (2021) · Brazilian Oral Research · doi:10.1590/1807-3107bor-2021.vol35.0031 · Cited by 5
Restorative thresholds for primary and permanent molars in children: French dentist decisions
Muller‐Bolla, M., Aïem, E., Coulot, C., Velly, A. M., & Doméjean, S. (2020) · International Journal of Paediatric Dentistry · doi:10.1111/ipd.12752 · Cited by 5
Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions
AL-Kaff, A. A., Alshehri, A. Z., Alasmari, R. A., Alsubaie, N., Aldaws, A., Althaqeel, A., Alshehri, R. S., & Alawaji, Y. M. (2025) · Cureus · doi:10.7759/cureus.87450 · Cited by 5
“Research indicates that sealed non-cavitated lesions demonstrate a diminished risk of progression relative to unsealed lesions, highlighting the safety and efficacy of sealant application [26].”
Influential
Eruption and caries status of first permanent molars in children aged 6–7 years in Shijingshan District, Beijing, China
Zhao, M., Wang, Z., Liu, M., Song, Z., Wang, R., & Yang, L. (2024) · BMC Oral Health · doi:10.1186/s12903-024-04915-1 · Cited by 4
Effectiveness of fissure sealants in 8- to 10-year-olds with and without molar–incisor hypomineralization (MIH) – results from a cross-sectional epidemiological study
Zöllner, F., Fresen, K.-F., Gaballah, R., Schill, H. I., Pitchika, V., Amend, S., Krämer, N., & Kühnisch, J. (2024) · Clinical Oral Investigations · doi:10.1007/s00784-024-06083-6 · Cited by 4
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Quality Measure Adherence and Oral Health Outcomes in Children
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Glass ionomer fissure sealants versus fluoride varnish application on children’s behaviour: a randomised controlled trial
Chiu, H. H. C., Lam, P. P. Y., & Yiu, C. K. Y. (2024) · European Archives of Paediatric Dentistry · doi:10.1007/s40368-024-00952-0 · Cited by 5
Evaluation of Ion Release from Four Dental Sealants
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A scoping review of caries risk management protocols in Australia and New Zealand
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Prevention in the context of caries-related extractions under general anaesthesia: an evaluation of the use of sealants and other preventive care by referring dentists
Raja, A., White, D. A., Kerr, S. E., & Dietrich, T. (2019) · BDJ · doi:10.1038/s41415-019-0729-1 · Cited by 4
Dental Sealants and Caries Prevention
Weatherspoon, D. J., & Crespin, M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-323-55484-8.00026-5 · Cited by 4
Demonstration of payer readiness for value‐based care in a fee‐for‐service environment: Measuring provider performance on sealant delivery
Martin, A. B., Kirby, H., Ayers, G., Kelly, A., Riley, A., & Boucher, S. (2020) · Journal of Public Health Dentistry · doi:10.1111/jphd.12414 · Cited by 4
Physicochemical and biological evaluation of a triazine-methacrylate monomer into a dental resin
García, I. M., Leitune, V. C. B., Rücker, V. B., Nunes, J. S., Visioli, F., & Collares, F. M. (2021) · Journal of Dentistry · doi:10.1016/j.jdent.2021.103818 · Cited by 4
Are sealants effective in preventing caries in primary molars?
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3-Year Clinical Performance of a New Pit and Fissure Sealant
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An Alternative Technique for Topical Application of Acidulated Phosphate Fluoride (APF) Gel: A Two-Years Double-Blind Randomization Clinical Trial (RCT)
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Advancements in Preventive Strategies and Enamel Regeneration: Navigating the Complexities of Dental Care in the Age of Technology
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Effect of Enamel Pretreatment Using Er,Cr: YSGG Laser Irradiation on Micro‐shear Bond Strength of a Self‐etch Fissure Sealant
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EVALUATION OF MICROLEAKAGE OF SILVER NANOPARTICLE-ADDED PIT AND FISSURE SEALANT IN PERMANENT TEETH (IN-VITRO STUDY)
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Authors: Ahovuo-Saloranta, A., Forss, H., Walsh, T., Nordblad, A., Mäkelä, M., & Worthington, H. V.
Affiliations: University of Tampere (FI)
Tampere University Hospital (FI)
University of Manchester (GB)
Ministry of Social Affairs and Health (FI)
THL (National Institute for Health and Welfare); PO Box 30 Helsinki Finland 00271
ORCID: Walsh, Tanya
Worthington, Helen V
Venue: Cochrane Database of Systematic Reviews
Publisher: Wiley
Published: 2017-07-31
Volume: 2017
Issue: 7
Pages: CD001830-CD001830
ISSN: 1361-6137 (ISSN-L)
1465-1858
DOI: 10.1002/14651858.cd001830.pub5
PMC: PMC6483295
OpenAlex: W2741425763
Cited by: 391
References: 188
Citations by year: 2026: 28 · 2025: 47 · 2024: 48 · 2023: 50 · 2022: 51 · 2021: 61 · 2020: 47 · 2019: 35 · 2018: 20 · 2017: 2
FWCI: 3.99
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm)
onlinelibrary.wiley.com/termsAndConditions (vor)
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
Research Explorer (The University of Manchester) (submittedVersion, other-oa)
STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
WOS
Topics: Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
Health Sciences › Dentistry › General Dentistry › Dental materials and restorations
Health Sciences › Dentistry › Oral Surgery › Endodontics and Root Canal Treatments
Keywords: pit and fissure sealants, dental caries prevention, permanent teeth, occlusal surface, resin-based sealers, glass ionomer sealants, sealants, children and adolescents, caries incidence, caries increment, molars, premolars, caries risk, risk of bias, quality of evidence, cost-effectiveness, cost-effectiveness analysis
MeSH terms: Acrylic Resins, Adolescent, Child, Child, Preschool, Dental Caries, Dental Occlusion, Humans, Molar, Pit and Fissure Sealants, Silicon Dioxide, Randomized Controlled Trials as Topic, Dentition, Permanent

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Pit and fissure sealants for preventing dental decay in permanent teeth

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