title: Longitudinal evaluation of sealing molars with and without incipient dental caries in a public health program.
abstract: OBJECTIVE
  This study undertook a retrospective evaluation of the effect of sealants on the caries experience of initially sound and incipient permanent first molar pit and fissure surfaces.
  
  
  METHODS
  Records of children with complete five-year records were obtained from a school-based dental sealant program in a fluoridated community. Sealants were placed on 677 tooth surfaces in 96 children; 120 tooth surfaces in 17 children who received baseline examinations were not sealed because of lack of caregiver consent. Tooth surfaces were initially diagnosed as being sound or having incipient lesions, and evaluated for caries status after five years.
  
  
  RESULTS
  For initially incipient surfaces the five-year decay rate was 10.8 percent (41 of 380 surfaces) for sealed surfaces and 51.8 percent (29 of 56 surfaces) for nonsealed surfaces with an odds ratio of 8.88 (95% CI = 4.56, 17.35). Initially sound surfaces had a decay rate of 8.1 percent (24 of 297 surfaces) for sealed surfaces and 12.5 percent (8 of 64 surfaces) for nonsealed surfaces with an odds ratio of 1.63 (95% CI = 0.63, 4.08). The two odds ratios were significantly different.
  
  
  CONCLUSIONS
  Initially sound tooth surfaces were unlikely to become decayed in five years, and did not benefit greatly from the application of sealants. Within the limitations of this study, there were clear efficiencies in sealing incipient, but not sound, surfaces. The targeting of teeth with incipient caries for sealants is therefore recommended.
authors.affiliation: Program in Dental Public Health, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Heller
authors.forename: S G
authors.initials: SG
authors.lastname: Reed
authors.forename: F W
authors.initials: FW
authors.lastname: Bruner
authors.forename: S A
authors.initials: SA
authors.lastname: Eklund
authors.forename: B A
authors.initials: BA
authors.lastname: Burt
mesh_terms: D017438:Bisphenol A-Glycidyl Methacrylate / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control*; D003750:Dental Fissures / Q000628:therapy; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008963:Molar; D015999:Multivariate Analysis; D016017:Odds Ratio; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D015397:Program Evaluation; D012189:Retrospective Studies; D012571:School Dentistry
chemical_list: D010895:Pit and Fissure Sealants; D017438:Bisphenol A-Glycidyl Methacrylate