Sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents when compared with no sealants or the use of fluoride varnish. Sealants also minimize the progression of noncavitated occlusal carious lesions. Sealant placement on those teeth at highest risk will give the greatest benefit. High-risk pits and fissures should be sealed as soon as possible. Low-risk pits and fissures may not require sealants. As caries risk may increase due to changes in patient habits, oral microflora, or physical condition, unsealed teeth might subsequently benefit from sealant application.
Dental sealants are available in an opaque, tinted, or clear form. Tinted and opaque sealants are easier to detect at subsequent dental examinations.
Studies incorporating recall and maintenance have reported sealant success levels of 80 % to 90 % after 10 or more years. Sealants are easily repaired or replaced if necessary. Two systematic reviews show 80 and 81% caries reduction due to sealant placement. The CDC and the Community Preventive Services Task Force both endorse school based sealant programs.
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