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Dental Sealants and Preventive Resins for Caries Prevention: A Review of the Clinical Effectiveness, Cost-effectiveness and Guidelines

Last updated: October 31, 2016
Project Number: RC0816-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of dental sealants and preventive resins for caries prevention when applied to permanent teeth in children?
  2. What is the comparative clinical effectiveness of dental sealants and preventive resins for different tooth groups (molars, bicuspids, incisors)?
  3. What is the cost-effectiveness of dental sealants and preventive resins?
  4. What is the comparative cost-effectiveness of dental sealants and preventive resins when applied to different tooth groups?
  5. What is the cost-effectiveness of dental sealants and preventive resins when applied at specific times after eruption and compared with no specified time interval?
  6. What are the evidence-based guidelines for the use of sealants and preventive resins?

Key Message

Three systematic reviews demonstrate that the application of dental sealants to occlusal surfaces of permanent first molars in children and adolescents prevents development of new carious lesions compared to no sealant use. There is evidence that this benefit is maintained up to 9 years. Four randomized controlled trials demonstrated conflicting results with respect to caries prevention of dental sealants compared to no dental sealants in children and adolescents. All four of these randomized controlled trials had a high risk of bias. One systematic review of economic analyses found that dental sealants are a cost-effective intervention for caries prevention in children and adolescents. One evidence based clinical practice guideline recommended the use of sealants on permanent molars with sound or non-cavitated occlusal surfaces in children and adolescents compared to no use of sealants. This was a strong recommendation based on moderate quality evidence. Overall, there is good quality evidence that demonstrates caries reduction when dental sealants are applied to permanent molars in children and adolescents compared to no dental sealant application. This intervention also appears to be cost-effective. There was no evidence that addressed the clinical or cost effectiveness of dental sealants with respect to different tooth groups or timing of application after tooth eruption.