title: Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: A report of the American Dental Association and the American Academy of Pediatric Dentistry.
abstract: This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits and fissures of occlusal surfaces.
  
  
  
  This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the US market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions.
  
  
  
  The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of noncavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others.
  
  
  
  These recommendations are designed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents. Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients. The authors recommend that clinicians reorient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents.
authors.forename: John T
authors.initials: JT
authors.lastname: Wright
authors.forename: James J
authors.initials: JJ
authors.lastname: Crall
authors.forename: Margherita
authors.initials: M
authors.lastname: Fontana
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Gillette
authors.forename: Brian B
authors.initials: BB
authors.lastname: Nový
authors.forename: Vineet
authors.initials: V
authors.lastname: Dhar
authors.forename: Kevin
authors.initials: K
authors.lastname: Donly
authors.forename: Edmond R
authors.initials: ER
authors.lastname: Hewlett
authors.forename: Rocio B
authors.initials: RB
authors.lastname: Quinonez
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Chaffin
authors.forename: Matt
authors.initials: M
authors.lastname: Crespin
authors.forename: Timothy
authors.initials: T
authors.lastname: Iafolla
authors.forename: Mark D
authors.initials: MD
authors.lastname: Siegal
authors.forename: Malavika P
authors.initials: MP
authors.lastname: Tampi
authors.forename: Laurel
authors.initials: L
authors.lastname: Graham
authors.forename: Cameron
authors.initials: C
authors.lastname: Estrich
authors.forename: Alonso
authors.initials: A
authors.lastname: Carrasco-Labra
mesh_terms: D000293:Adolescent; D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D055094:Evidence-Based Dentistry; D005460:Fluorides, Topical / Q000627:therapeutic use; D006801:Humans; D008963:Molar; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*
chemical_list: D005460:Fluorides, Topical; D010895:Pit and Fissure Sealants
keywords: Pit-and-fissure sealants; caries arresting; caries prevention; clinical recommendations; guideline; occlusal caries