Evidence-based clinical recommendations for the use of pit-and-fissure sealants: a report of the American Dental Association Council on Scientific Affairs.
BACKGROUND
This article presents evidence-based clinical recommendations for use of pit-and-fissure sealants developed by an expert panel convened by the American Dental Association Council on Scientific Affairs. The panel addressed the following clinical questions: Under what circumstances should sealants be placed to prevent caries? Does placing sealants over early (noncavitated) lesions prevent progression of the lesion? Are there conditions that favor the placement of resin-based versus. glass ionomer cement sealants in terms of retention or caries prevention? Are there any techniques that could improve sealants' retention and effectiveness in caries prevention?


METHODS
Staff of the ADA Division of Science conducted a MEDLINE search to identify systematic reviews and clinical studies published after the identified systematic reviews. At the panel's request, the ADA Division of Science staff conducted additional searches for clinical studies related to specific topics. The Centers for Disease Control and Prevention also provided unpublished systematic reviews that since have been accepted for publication.


RESULTS
The expert panel developed clinical recommendations for each clinical question. The panel concluded that sealants are effective in caries prevention and that sealants can prevent the progression of early noncavitated carious lesions.


CONCLUSIONS
These recommendations are presented as a resource to be considered in the clinical decision-making process. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. The evidence indicates that sealants can be used effectively to prevent the initiation and progression of dental caries.
Beauchamp
Jean
J
American Dental Association, Chicago, USA.
Caufield
Page W
PW
Crall
James J
JJ
Donly
Kevin
K
Feigal
Robert
R
Gooch
Barbara
B
Ismail
Amid
A
Kohn
William
W
Siegal
Mark
M
Simonsen
Richard
R
D000293:Adolescent; D000328:Adult; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D001840:Dental Bonding; D003731:Dental Caries / Q000517:prevention & control*; D003750:Dental Fissures / Q000517:prevention & control; D019317:Evidence-Based Medicine; D005899:Glass Ionomer Cements; D006801:Humans; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D019279:Resin Cements
D002327:Cariostatic Agents; D005899:Glass Ionomer Cements; D010895:Pit and Fissure Sealants; D019279:Resin Cements