4 - Effectiveness of Resin Sealants in a High Caries Risk Population

Abstract:

Purpose: Despite the placement of sealants following recommended guidelines, a high incidence of caries was observed at subsequent recall appointments at a pediatric dental residency program. This study was undertaken to determine incidence of disease and predictors of morbidity.

Methods: This retrospective open cohort study collected and analyzed data from patients of record at Nicklaus Children’s Pediatric Dentistry Department. Charts of children ages 6-18 at the time of initial sealant placement on permanent 1st molars between January 2016 and January 2023 were reviewed. Sealant placement and development of carious lesions were documented at 6 month recall intervals. Factors such as sealant placement location, Frankl score, recall frequency, ASA classification, and gender were evaluated.

Results: Data was collected for 600 children and a total of 2,680 sealants were placed. The sample was mostly composed of male patients, 51%, who were ASA I, 66.9%, with a median age of 13.5 years. The primary place of sealant placement was in the outpatient dental clinic (94%). Out of the total number of teeth sealed, 19% developed carious lesions. Morbidity was limited to a particular subgroup, 22% or 132 children. The lesion most commonly found on the occlusal surface (63.7%).

Conclusion: Although pit and fissure sealants are widely used, their effectiveness in high caries-risk populations seems to be limited. Carious lesions on a high-risk patient population persist suggesting a need for enhanced education for families, tailored preventive regimes and increased periodicity of preventive visits.