Pit and Fissure Sealants

Pit and fissure sealants are professional, ‘in office’ treatments which require good patient cooperation. For resin-based sealants, the tooth must be thoroughly cleaned and dried prior to application. After etching of the enamel, sealants are applied in a thin layer and cured by visible light before the occlusion is checked. Glass ionomer cements are less sensitive to moisture and require no etching of the enamel.

Pit and fissure sealants are effective in preventing caries in permanent molars provided that the sealants are regularly controlled and repaired when needed. The preventive fraction is 71% up to five years after placement with a moderate quality of evidence [1]. The prevented fraction is lower in primary molars. Glass ionomer sealants are equally as effective in caries prevention, however require greater maintenance due to an impaired retention rate [2].

Pit and fissure sealants are available from several brands and are generally recognized as safe. Patients may however be allergic to uncured leaking monomers from the material.

The use of pit and fissure sealants is the most time consuming professional preventive measure and does not pay off in low-caries populations. Sealants may be cost-effective for individuals who are at high risk of caries [3]. The cost of sealant programs is decreased when performed by dental hygienists.

Pit and fissure sealants are recommended for children who are at a moderate or high risk of developing dental caries, or have early caries lesions in pits and fissures.