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JADA Continuing Education

Background. The authors examined the risk of caries development in teeth with partially or fully lost sealant (formerly sealed [FS] teeth) relative to the risk in teeth that never have received sealants (never-sealed [NS] teeth).

Methods. The authors searched the population of studies used in five reviews of sealant effectiveness as established in split-mouth design studies involving resin-based sealants with no reapplication of lost sealant. They required included studies to contain sufficient data to estimate the risk of caries in FS teeth relative to that in NS teeth and its 95 percent confidence interval (CI). To estimate the mean RR by year since sealant placement, they used a weighted bivariate model and tested for heterogeneity using the quantity I².

Results. The weighted mean RR was 0.998 (95 percent CI, 0.817–1.220) one year after placement (four studies, 345 tooth pairs) and 0.936 (95 percent CI, 0.896–0.978) at four years (five studies, 1,423 tooth pairs).

Conclusions. Teeth with fully or partially lost sealant were not at a higher risk of developing caries than were teeth that had never been sealed.

Clinical Implications. Inability to provide a retention-check examination to all children participating in school sealant programs because of loss to follow-up should not disqualify a child from receiving sealants.

Key Words: Dental sealants; pit-and-fissure sealants; retention; caries

Abbreviations: CDC: Centers for Disease Control and Prevention. • CWF: Community water fluoridation. • FMR: Fluoride mouthrinse. • FS: Formerly sealed. • M: Permanent molar. • NA: Not applicable. • NR: Not reported. • NS: Never sealed. • PM: Permanent premolar. • RB1: Ultraviolet light–polymerized resin-based sealant. • RB2: Autopolymerized resin-based sealant. • VT: Visual/tactile. • Y1: Year 1. • Y1.5: Year 1.5. • Y2: Year 2. • Y3: Year 3. • Y4: Year 4. • Y4.5: Year 4.5.

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				B. F. Gooch, S. O. Griffin, S. K. Gray, W. G. Kohn, R. G. Rozier, M. Siegal, M. Fontana, D. Brunson, N. Carter, D. K. Curtis, et al. Preventing Dental Caries Through School-Based Sealant Programs: Updated Recommendations and Reviews of Evidence J Am Dent Assoc, November 1, 2009; 140(11): 1356 - 1365. [Abstract] [Full Text] [PDF]

				R. H. Beaumont SEALANTS REVISITED J Am Dent Assoc, August 1, 2009; 140(8): 969 - 970. [Full Text] [PDF]