title: Integrity, maintenance and caries susceptibility of sealed surfaces in adolescents receiving regular care from general dental practitioners in Scotland.
abstract: Pit and fissure sealants (sealants) are recognized as an effective caries preventive measure. The aim of this study was to assess the fate of occlusal surface sealants in a sample of 'regularly' attending adolescent patients (mean age 12.5 years at baseline) of 41 general dental practitioners, participating in a 3-year prospective clinical trial. A subsidiary aim was to compare the caries status of completely sealed surfaces with that of inadequately sealed surfaces over the same period. Baseline and three annual follow-up examinations were conducted by one trained and calibrated examiner under optimal conditions (dental chair, operating light, and compressed air). Sealed occlusal surfaces were evaluated for sealant type, sealant coverage, and caries status of the surface. Data for the initial and final year examinations were available for 402 subjects, who had 1377 sealants at baseline. Surfaces with optimal sealant coverage at baseline (n = 592) were significantly less likely to have become decayed (dentinal caries) or to have been restored by year 4 than surfaces with less than complete coverage (P < 0.001). Considering sealant maintenance during the study, 484 of the sealants were of optimal coverage (covered the fissure system) at the final examination. However, only 135 surfaces demonstrated evidence of maintenance by attaining optimal coverage. It is concluded that the fissure sealants in this sample may not have received the regular maintenance required to ensure full surface coverage and thus provide maximal caries protection, as inadequately sealed surfaces were more likely to decay than completely sealed surfaces.
authors.affiliation: Dental Health Services Research Unit, Dundee Dental Hospital and School, University of Dundee, UK.
authors.forename: C
authors.initials: C
authors.lastname: Deery
authors.forename: H E
authors.initials: HE
authors.lastname: Fyffe
authors.forename: Z
authors.initials: Z
authors.lastname: Nugent
authors.forename: N M
authors.initials: NM
authors.lastname: Nuttall
authors.forename: N B
authors.initials: NB
authors.lastname: Pitts
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D003733:Dental Caries Susceptibility / Q000187:drug effects; D005792:General Practice, Dental; D006801:Humans; D008137:Longitudinal Studies; D010895:Pit and Fissure Sealants / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012606:Scotland
chemical_list: D010895:Pit and Fissure Sealants