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APHA Scientific Session and Event Listing

Ella M. Oong, DMD, MPH¹, Susan O. Griffin, PhD¹, Barbara F. Gooch, DMD, MPH¹, William Kohn, DDS¹, and Kari Jones, PhD². (1) DOH, CDC, 4770 Bufford Hwy, MS F10, Atlanta, GA 30341, 917-992-7031, eoong@post.harvard.edu, (2) National Center for Health Marketing, Division of Partnerhip Communications, Centers for Disease Control and Prevention, 4770 Buford Highway; MS K-39, Atlanta, GA 30341

Background: Although there is strong evidence that sealants are effective in preventing caries, sealant prevalence remains well below national targets. Surveys of dentists suggest a common barrier to providing sealants is concern about inadvertently sealing caries. This research examines caries progression in sealed tooth surfaces.

Methods: We systematically reviewed the literature for studies that examined tooth survival (percentage of lesions that did not progress) in sealed (S) and not sealed (NS) carious tooth surfaces. Our inclusion criteria were resin-based or glass-ionomer cement sealant material and sealants applied to known carious lesions in permanent posterior teeth.

Results: Ten studies were included in the final body of evidence – four before/after, three retrospective cohort, one prospective cohort, and two randomized control trials. Six studies had concurrent controls. Caries assessment was performed with combinations of visual tactile, radiographic, and Bodecker measurement exams. Among ten studies with caries progression information for sealed lesions (20 observations over multiple time periods), survival ranged from 50 to 100% (mean=83%; median=85%). Among unsealed lesions (seven observations), survival ranged from 0 to 94% (mean=54%; median=66%). Among the studies with comparison groups (only one observation per study), the mean and median differences in survival between sealed and not sealed lesions were, respectively, 35 and 32 percentage points. Four of these studies tested if the difference between sealed and not sealed was statistically significant and found that survival was lower in unsealed lesions.

Conclusions: Although quality of study design and execution were limited, all studies found that sealing caries reduced caries progression.

Learning Objectives:

• Understand association between sealants and caries progression.
• Describe quality of evidence on effectiveness of sealants in managing caries.

Keywords: School-Based Programs, Oral Health Outcomes

Presenting author's disclosure statement:

Not Answered