We want to thank Dr. John Sinclair for his interest in our response to Dr. Jeffrey Trester’s letter to the editor. Dr. Sinclair noted a concern related to our recommendation "that a 15 DIAGNOdent reading is a good candidate for sealing."
He noted, "When sealants microscopically loosen, dentin decay can accelerate and be impossible to diagnose until the decay has seriously compromised a tooth’s health." Although this may seem to be a valid concern, there are five-and 10-year clinical studies1,2 showing that sealing carious lesions can successfully prevent further destruction of tooth structure.
Dr. Sinclair’s opinion concerning "placing a fluoride containing glass ionomer in suspicious pits and fissures is preferable to a nonfluoride sealant," is not supported by a recent article by Poulsen and others.3 They found that the glass-ionomer sealant tested in their study had poorer retention and less caries protective effect than the resin-based sealant.
We completely agree with Dr. Sinclair’s comment that "it is very important to consider each patient’s caries-prone history when deciding whether to fill or not to fill." Each patient is unique and deserves treatment that takes into account all the factors that can affect their caries status.
TOP
REFERENCES
