Sealants and dental caries

The authors conducted a study to survey the perspectives of dentists
regarding the 2010 American Dental Association (ADA) recommendation to seal noncavitated carious lesions (NCCLs) in children and young adults.

Methods

The authors mailed a questionnaire
to a randomly selected sample of 2,400 general dentists
(GDs) and pediatric dentists (PDs) in the United States.
The sample was chosen by the ADA’s Survey Center. The
questionnaire included two photographs of NCCLs (permanent
first molar and premolar) in a 12-year-old child. Respondents
were provided with radiographic findings and asked to
choose from several management options.

Results

In the absence of radiographic evidence of caries,
37.4 percent and 42.3 percent of GDs and PDs, respectively,
indicated that they would seal the NCCL in the molar. For
the premolar, a significantly lower percentage of GDs than of
PDs indicated that they would seal the NCCL. With radiographic
evidence of caries in dentin, less than 4 percent of all
dentists surveyed indicated that they would seal the NCCLs,
and more than 90 percent indicated that they would remove
the caries and place restorations. Less than 40 percent of
dentists indicated that they sealed NCCLs in their practice.
Conclusions. The U.S. dentists surveyed have not adopted
evidence-based clinical recommendations regarding the
sealing of NCCLs.

Practice Implications

New educational and dissemination
programs should be developed regarding these evidence-based
caries management approaches.

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