283 - Effectiveness of Second Molar Sealants in Preventing Caries

Purpose: The assessment of caries risk considers multiple factors including diet, fluoride exposure, and oral microbiome. The American Academy of Pediatric Dentistry recommends sealants to prevent pit-and-fissure caries on permanent molars in children and adolescents. This retrospective cohort study seeks to evaluate whether the presence of second molar sealants prevents caries in high-risk adolescents in Rochester, NY who received treatment at the Eastman Institute for Oral Health (EIOH)
 

Methods: Patient records from EIOH's department of pediatric dentistry, spanning from January 1, 2014, to December 31, 2018, will be reviewed. Patients between 11 to 15 years old will be included. Patients will be divided into two groups: those who received dental sealants on their second molars and those who did not. Patient records will be examined to see if they required occlusal/buccal/lingual restorations, endodontic treatment, and/or extractions on any of their second molars. Demographic data, including sex, race, ethnicity, and insurance type, will also be collected. Statistical analyses, including chi-squared tests and logistic regression, will be conducted to compare groups and adjust for confounding variables such as age,  gender, race, and ethnicity.

Results: 7,570 individuals met the inclusion criteria for this study. 2,246 individuals received sealants and/ or treatment on one or more of their second molars. Of the individuals who did not receive a sealant, 87% did not have a cavity, while 13% did have a cavity. Of the individuals who did receive a sealant, 58.5% did not have a cavity, and 41.5% developed caries a cavity. Chi-square tests conducted on a sample of 7,570 individuals revealed a significant association between sealant application and the occurrence of cavities. All tests, including Chi-Square (2542.36, p < 0.0001), Likelihood Ratio Chi-Square (2164.52, p < 0.0001), and Mantel-Haenszel Chi-Square (2542.36, p < 0.0001), showed strong significance, indicating that sealant use is linked to a reduced likelihood of cavities. Fisher’s Exact Test (two-sided and left-sided) also confirmed these findings (p < 0.0001). However, the right-sided Fisher’s Exact Test returned a p-value of 1.000, suggesting no significant association for this test. These results strongly suggest that sealants are significantly associated with a lower risk of cavities.

Conclusion: This study highlights the effectiveness of second molar sealants in reducing caries risk among high-risk adolescents in Rochester, NY. Of the 7,570 individuals analyzed, 58.5% of those with sealants remained cavity-free, compared to 87% of those without sealants. Despite the positive impact of sealants, 41.5% of individuals with sealants still developed cavities, suggesting that other factors like diet and oral hygiene may also influence caries development. Statistical analysis confirmed a significant association between sealant use and reduced cavity risk. While sealants are effective, they are not a complete solution, and further research is needed to explore additional preventive measures.