Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: A report of the American Dental Association and the American Academy of Pediatric Dentistry

John T. Wright, James J. Crall, Margherita Fontana, E. Jane Gillette, Brian B. Nový, Vineet Dhar, Kevin Donly, Edmond R. Hewlett, Rocio B. Quinonez, Jeffrey Chaffin, Matt Crespin, Timothy Iafolla, Mark D. Siegal, Malavika P. Tampi, Laurel Graham, Cameron Estrich, Alonso Carrasco-Labra

Research output: Contribution to journalArticlepeer-review

90 Scopus citations

Abstract

Background This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits and fissures of occlusal surfaces. Types of Studies Reviewed This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the US market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions. Results The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of noncavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others. Conclusions and Practical Implications These recommendations are designed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents. Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients. The authors recommend that clinicians reorient their efforts toward increasing the use of sealants on the occlusal surfaces of primary and permanent molars in children and adolescents.

Original languageEnglish (US)
Pages (from-to)672-682.e12
JournalJournal of the American Dental Association
Volume147
Issue number8
DOIs
StatePublished - Aug 1 2016

Keywords

  • Pit-and-fissure sealants
  • caries arresting
  • caries prevention
  • clinical recommendations
  • guideline
  • occlusal caries

ASJC Scopus subject areas

  • Dentistry(all)

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