Pit and fissure sealants or fluoride varnishes?

Authors:

ABSTRACT

Conclusion

Despite the general advances in dental care, dental caries is still a global health problem affecting many children. Occlusal
surfaces of first permanent molars are the most susceptible sites in the developing permanent dentition. Dentists should use sealants or
fluoride varnish - as well as other means - to limit the onset of tooth decay. Application of sealants is a recommended procedure to
prevent or control caries. Sealing occlusal surfaces of newly erupted permanent molars in children and teenagers delays caries onset
up to 48 months compared with unsealed teeth. However longer follow-ups shows a reduction of the preventive effect [Tikhonova et al.,
2015]. A review of 2013 pointed out how sealants are effective in high risk children, however information about the benefits of sealing in
other conditions is still scant [Ahovuo-Saloranta et al., 2013]. Fluoride varnishes are frequently used to prevent early childhood caries
and reduce caries increment in very young children [Weintraub et al., 2006] and in the most vulnerable populations, where the
prevalence of caries is higher and specialist visits are occasional [Chu et al., 2010]. Many studies have reported the effectiveness of
different types and forms of fluoride agents in preventing dental caries among children and adolescents [Divaris et al., 2013]. A review
clarifies that professional application of a 5% sodium fluoride varnish leads to remineralisation of early enamel caries in children.
Solutions of 38% silver diamine fluoride are effective in arresting active dentine caries [Gao et al., 2016]. The last systematic review
[Ahovuo-Saloranta et al., 2016], comparing pit and fissure sealants with fluoride varnishes explains that the pooled estimate slightly
favours resin sealants over fluoride varnishes at two years. At four and nine years, the only comparative study (with high drop-out rates)
found more caries on fluoride-varnished occlusal surfaces than on resin-sealed surfaces. There is evidence suggesting the superiority of
resin-based fissure sealants over fluoride varnishes for prevention of occlusal caries in permanent molars, however it is not relevant.
Eventually, Ahovuo-Saloranta et al. state that current data do not allow to draw definitive conclusions on whether to apply sealants or
fluoride varnishes on occlusal surfaces of permanent molars [2016]. We will publish your opinion and experiences related to this topic in
the next EJPD issue: join the discussion and write a letter to the editor!

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