Caries sealing in permanent teeth

Abstract

Although numerous strategies are available for the management of carious lesions, one of the strategies with the highest level of supporting evidence for the prevention of lesions as well as for the arrest of non-cavitated lesions and management of the bacterial contamination are dental sealants. Providing sealants in private practice settings as well as in public programs is not only effective, but can be cost-effective especially when targeting high caries risk individuals or groups. More advanced or deeper cavitated lesions can be sealed from the oral environment resulting in lesion arrest but require a stronger material than a dental sealant or use of different techniques, such as Hall crowns, etc. To aid in deciding if a sealant is an appropriate intervention, teeth should be clean, dry, and well illuminated for visual assessment, forceful use of a probe should be avoided, and radiographs and other diagnostic technologies are not necessary for the sole purpose of placing sealants. Regarding the material of choice, as more studies have become available the differences between resin composite and glass ionomer cement materials used as sealants have been less clear to discern, thus it is important to take into account the likelihood of experiencing lack of retention when choosing the material to use. However, even with the strong supporting evidence for sealant use, utilization is still low. Education and training, coupled with a fairer pay scheme, is a reasonable approach to increase provision of sealants.