Techniques for assessing tooth surfaces in school-based sealant programs.
BACKGROUND
The authors reviewed the evidence supporting current guidelines for the detection of cavitated carious lesions. Currently, cavitation is the point at which sealants are not placed in school-based programs.


METHODS
The authors did not perform a formal systematic review. However, they examined existing systematic reviews of caries detection and diagnosis, including those presented at the 2001 National Institutes of Health Consensus Conference on Management of Caries, published evidence related to the International Caries Detection and Assessment System criteria and other peer-reviewed publications. Where the authors found ambiguity or uncertainty in the evidence, they consulted with fellow members of an expert work group.


RESULTS
Visual examination is appropriate and adequate for caries assessment before placing sealants. The clinician should not use an explorer under force. Radiographs are not indicated solely for the placement of sealants, and the use of magnification and caries detection devices is not necessary to determine cavitation.


CONCLUSIONS
This report focuses on tooth assessment, in particular the detection of carious lesion cavitation in school-based sealant programs. These recommendations must be balanced with the dentist's expertise, available treatment options, the patient's preferences and access to care.
Fontana
Margherita
M
Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, 1011 N. University, Ann Arbor, MI 48109, USA. mfontan@umich.edu
Zero
Domenick T
DT
Beltrán-Aguilar
Eugenio D
ED
Gray
Shellie Kolavic
SK
D002648:Child; D003731:Dental Caries / Q000175:diagnosis*; D003743:Dental Enamel / Q000473:pathology; D006801:Humans; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D012571:School Dentistry / Q000379:methods*; D012680:Sensitivity and Specificity
D010895:Pit and Fissure Sealants