Pit-and-fissure sealants are one of the most effective – yet underutilized – interventions for preventing caries, especially among children. New guidelines
from the ADA Council on Scientific Affairs and the American Academy of Pediatric Dentistry confirm the effectiveness of sealants. Nonetheless, misperceptions still exist, and five of them are discussed below.
Misperception 1: The ADA has not stated a position on dental sealants.
For a number of years, the ADA Council on Scientific Affairs has recommended placing sealants on the primary and permanent molars of all children and adolescents to prevent caries. The Council also recommends
dentists use pit-and-fissure sealants rather than fluoride varnish for the purposes of sealing the occlusal surfaces of molars.
Misperception 2: But isn’t fluoride varnish just as effective as dental sealants for preventing occlusal caries lesions?
No. Although fluoride varnish performs an important function in terms of preventing caries generally in at-risk patients,9
data from three studies10-12
with nearly 2,000 total participants revealed those who received pit-and-fissure sealants on occlusal surfaces saw a 73% reduction in the risk of developing new caries lesions, compared to those participants who received only fluoride varnishes.
Misperception 3: Young patients could become exposed to concerning levels of bisphenol A (BPA) when receiving dental sealants.
The potential amount of BPA
patients could be exposed to when receiving sealants is miniscule, and it’s less than the amount a person receives from breathing air or handling a receipt. There is no evidence of patients experiencing adverse effects caused by BPA in dental sealants
(see “Bisphenol A and Dental Sealants” section, following).
Misperception 4: Sealants are not reimbursable under many dental plans.
Many dental plans will cover sealants (CDT code 1351) on children’s teeth. There are cost savings to patients from the prevention of non-cavitated caries lesions (which do not require treatment).
Misperception 5: Sealants should not be placed over initial caries (non-cavitated caries lesions) in the primary or permanent molars.
In addition to being effective for primary prevention of caries lesions, evidence
indicates that sealants can also halt the progression of existing non-cavitated caries lesions in the teeth to which they are applied.