title: The effect of dental sealants on bacteria levels in caries lesions: a review of the evidence.
abstract: BACKGROUND
  Concern about inadvertently sealing over caries often prevents dentists from providing dental sealants. The objective of the authors' review was to examine the effects of sealants on bacteria levels within caries lesions under dental sealants.
  
  
  METHODS
  The authors searched electronic databases for comparative studies examining bacteria levels in sealed permanent teeth. To measure the effect of sealants on bacteria levels, they used the log(10) reduction in mean total viable bacteria counts (VBC) between sealed and not-sealed caries and the percentage reduction in the proportion of samples with viable bacteria.
  
  
  RESULTS
  Six studies--three randomized controlled trials, two controlled trials and one before-and-after study-were included in the analysis. Although studies varied considerably, there were no findings of significant increases in bacteria under sealants. Sealing caries was associated with a 100-fold reduction in mean total VBC (four studies, 138 samples). Sealants reduced the probability of viable bacteria by about 50.0 percent (four studies, 117 samples).
  
  
  CONCLUSIONS
  The authors found that sealants reduced bacteria in carious lesions, but that in some studies, low levels of bacteria persisted. These findings do not support reported concerns about poorer outcomes associated with inadvertently sealing caries.
  
  
  CONCLUSIONS
  Practitioners should not be reluctant to provide sealants-an intervention proven to be highly effective in preventing caries-because of concerns about inadvertently sealing over caries.
authors.affiliation: Centers for Disease Control and Prevention/Division of Oral Health/Surveillance, Investigations, and Research Branch, Chamblee, GA, USA.
authors.forename: Ella M
authors.initials: EM
authors.lastname: Oong
authors.forename: Susan O
authors.initials: SO
authors.lastname: Griffin
authors.forename: William G
authors.initials: WG
authors.lastname: Kohn
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Gooch
authors.forename: Page W
authors.initials: PW
authors.lastname: Caufield
mesh_terms: D002327:Cariostatic Agents / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003731:Dental Caries / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D013295:Streptococcus mutans / Q000302:isolation & purification
chemical_list: D002327:Cariostatic Agents; D010895:Pit and Fissure Sealants