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Pediatric Dentistry 2015The purpose of this paper was to review the chronology of dental sealant guideline developments and changes in recommendations regarding sealant usage by various state,... (Review)
Review
The purpose of this paper was to review the chronology of dental sealant guideline developments and changes in recommendations regarding sealant usage by various state, national, and international organizations between 2002 and 2014. More specific objectives include: (1) review and summarize the findings of systematic evidence-based reviews and recommendations regarding the use of pit and fissure sealants published since the 2002 American Academy of Pediatric Dentistry Pediatric Restorative Dentistry Consensus Conference; (2) identify consistencies and changes in conclusions or recommendations regarding the use of pit and fissure sealants, and differences in the methods used to develop recommendations/guidelines over time; and (3) describe the purpose and scope of current efforts to update American Dental Association 2008 Evidence-based Clinical Recommendations for the Use of Pit and Fissure Sealants. A summary of recommendations based on experts' synthesis of published evidence and recommendations is included.
Topics: Consensus Development Conferences as Topic; Dental Bonding; Dental Caries; Disease Progression; Evidence-Based Dentistry; Glass Ionomer Cements; Humans; Pit and Fissure Sealants; Practice Guidelines as Topic; Resin Cements
PubMed: 25905651
DOI: No ID Found -
Journal of the American Dental... Aug 2016National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly one-fourth of children and over one-half of adolescents... (Review)
Review
Sealants for preventing and arresting pit-and-fissure occlusal caries in primary and permanent molars: A systematic review of randomized controlled trials-a report of the American Dental Association and the American Academy of Pediatric Dentistry.
BACKGROUND
National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly one-fourth of children and over one-half of adolescents experienced dental caries in their permanent teeth. The purpose of this review was to summarize the available clinical evidence regarding the effect of dental sealants for the prevention and management of pit-and-fissure occlusal carious lesions in primary and permanent molars, compared with a control without sealants, with fluoride varnishes, or with other head-to head comparisons.
TYPE OF STUDIES REVIEWED
The authors included parallel and split-mouth randomized controlled trials that included at least 2 years of follow-up, which they identified using MEDLINE (via PubMed), Embase, LILACS, the Cochrane Central Register of Controlled Trials, and registers of ongoing trials. Pairs of reviewers independently conducted the selection of studies, data extraction, risk of bias assessments, and quality of the evidence assessments by using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Of 2,869 records screened, the authors determined that 24 articles (representing 23 studies) proved eligible. Moderate-quality evidence suggested that participants who received sealants had a reduced risk of developing carious lesions in occlusal surfaces of permanent molars compared with those who did not receive sealants (odds ratio [OR], 0.15; 95% confidence interval [CI], 0.08-0.27) after 7 or more years of follow-up. When the authors compared studies whose investigators had compared sealants with fluoride varnishes, they found that sealants reduced the incidence of carious lesions after 7 or more years of follow-up (OR, 0.19; 95% CI, 0.07-0.51); however, this finding was supported by low-quality evidence. On the basis of the evidence, the authors could not provide a hierarchy of effectiveness among the studies whose investigators had conducted head-to-head comparisons. The investigators of 2 trials provided information about adverse events, but they did not report any adverse events.
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Available evidence suggests that sealants are effective and safe to prevent or arrest the progression of noncavitated carious lesions compared with a control without sealants or fluoride varnishes. Further research is needed to provide information about the relative merits of the different types of sealant materials.
Topics: Adolescent; Child; Dental Caries; Dental Fissures; Humans; Molar; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Tooth, Deciduous
PubMed: 27470524
DOI: 10.1016/j.adaj.2016.06.003 -
International Journal of Dental Hygiene Feb 2017Dental sealants have proved to be an effective approach to prevent pit and fissure caries. This study examines the knowledge, opinion, values and practice (KOVP) of...
OBJECTIVES
Dental sealants have proved to be an effective approach to prevent pit and fissure caries. This study examines the knowledge, opinion, values and practice (KOVP) of dental hygienists concerning sealant use in the southwest region of Andalusia, Spain.
METHODS
Spanish dental hygienists (n = 400) volunteered to complete a 31-item, self-administered, pretested questionnaire to assess their knowledge, opinion, values and practice regarding pit and fissure sealants. Wilcoxon matched-pairs signed ranks test, the Friedman nonparametric repeated-measures anova and Spearman's correlation were used to analyse the data.
RESULTS
The mean scores for knowledge, opinion, values and practice were 3.57 ± 0.41; 2.17 ± 0.42; 2.58 ± 0.77 and 3.56 ± 0.46, respectively. Knowledge differed by years of experience (P < 0.01) and place of work (P < 0.01); opinion differed by years of experience (P = 0.03) and sector (P < 0.01). Similarly, practice about sealants differed by years of experience (P < 0.01). Conversely, values around sealant placement did not statistically differ by sex, years of experience, practice sector or place of work. Statistically, significant correlations were found between knowledge, opinion and value, while it was found no significant correlation between practice and the other variables (P > 0.05).
CONCLUSIONS
Most dental hygienists have sufficient knowledge about pit and fissure sealants. They also acknowledge the importance of use of dental sealants and have positive opinion/attitude about using sealants. Practice of dental sealants in clinics was found adequate. However, they were not following the specific guidelines and standardized procedures.
Topics: Attitude of Health Personnel; Dental Hygienists; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Pit and Fissure Sealants; Spain; Surveys and Questionnaires
PubMed: 26215758
DOI: 10.1111/idh.12167 -
Pediatric Dentistry Sep 2017
Topics: Child; Crowns; Dental Care for Children; Dental Materials; Dental Restoration, Permanent; Dental Restoration, Temporary; Dentition, Permanent; Esthetics, Dental; Humans; Pit and Fissure Sealants; Tooth, Deciduous
PubMed: 29179371
DOI: No ID Found -
Journal of Equine Veterinary Science Feb 2023Equine dental diseases are often underdiagnosed and their signs inadequately reported. Many horse owners have difficulties in recognizing pain-related behavioral signs...
Equine dental diseases are often underdiagnosed and their signs inadequately reported. Many horse owners have difficulties in recognizing pain-related behavioral signs and in associating them with dental pain. Our objective was to determine what type and degree of dental findings may cause behavioral signs associated with dental pain. In this cross-sectional study, dental examination was performed on 183 adult horses and cheek tooth findings were scored. Owners filled in an internet-based questionnaire including 35 questions concerning eating behavior, bit behavior, and general behavior of the horse. Descriptive statistics and logistic regression analyses were performed. Broadened or darkened fissures [odds ratio (OR) 2.4, 95% confidence interval (CI) 1.04-5.7), complicated fractures (OR 2.3, CI 1.01-5.2) and secondary dentine defects of at least the second degree (OR 3.1, CI 1.2-7.7) were associated with the expression of at least five behavioral signs in the univariable binomial logistic regression analyses. Horses with at least one of these potentially painful cheek tooth findings expressed more signs related to eating behavior, bit behavior, and general behavior than did the other horses. The results suggest that cheek tooth findings indicated by this study as being potentially painful, i.e. broadened or darkened fissures, complicated fractures and secondary dentine defects of at least the second degree, may require intervention, particularly if the horse expresses any behavioral signs that might be related to dental pain.
Topics: Horses; Animals; Cheek; Cross-Sectional Studies; Horse Diseases
PubMed: 36566909
DOI: 10.1016/j.jevs.2022.104198 -
Cureus Mar 2023It is important to provide appropriate dental care for newly erupted permanent first molars (PFMs) since they are susceptible to caries. As the coronavirus disease 2019...
BACKGROUND AND AIM
It is important to provide appropriate dental care for newly erupted permanent first molars (PFMs) since they are susceptible to caries. As the coronavirus disease 2019 (COVID-19) pandemic has led to significant changes in the way dental services are provided to patients, the purpose of this study is to examine the procedure records assigned to PFMs of 6-15 year-olds during the pandemic and analyze the restorative material preferences of the residents of public dental hospitals.
MATERIALS AND METHODS
Procedure records of patients aged between 6-15 years were extracted from the Public Oral and Dental Health Center, Bursa, Türkiye. All teeth groups except PFMs were excluded, while extracted, survived (restorative/endodontic/prosthetic procedures), and prevented (fissure sealant application) PFMs were analyzed retrospectively. Furthermore, restorative material preferences were analyzed by arch location, cavity surfaces, and dentition types.
RESULTS
Strong positive correlation was seen between age and PFM extraction (r=0.973; p<0.001) and age and PFM restorative treatments (r= 0.966; p<0.001); a negative correlation was detected between age and fissure sealants (r= -0.984; p<0,001) performed on PFMs of 8-15-year-olds. Amalgam was most often preferred as the restorative material (p<0.05).
CONCLUSION
The distribution of treatments and dental restorations can vary based on many factors, and the pandemic conditions may have changed treatment preferences to favor preventive dentistry. The excess of multi-surface restorations may be related to the delay of treatment applications during COVID-19.
PubMed: 36945234
DOI: 10.7759/cureus.36394 -
BMC Oral Health Oct 2023In South Africa, an estimated 85% of the population relies on the public sector for oral health services. With poor infrastructure and inadequate personnel, over 80% of...
BACKGROUND
In South Africa, an estimated 85% of the population relies on the public sector for oral health services. With poor infrastructure and inadequate personnel, over 80% of children with dental caries remain untreated. To reduce this burden of disease, one key goal is to promote good oral health and address oral diseases through prevention, screening, and treatment among children. While all policies have been proven to be effective in the control and prevention of dental caries, it is unclear which of those strategies provide value for money. This study evaluated five caries preventative strategies in terms of the cost and benefits among South African school children.
METHODS
The study uses a hypothetical South African population of school aged learners aged 5-15. The context and insights of the strategies utilized at the schools were informed by data from both grey and published literature. Using Markov modeling techniques, we conducted a cost-effectiveness analysis of Acidulated Phosphate Fluoride (APF) application, atraumatic restorative treatment (ART), sugar-reduction and fissure sealants. Markov model was used to depict the movement of a hypothetical patient cohort between different health states over time. We assessed both health outcomes and costs of various interventions. The health outcome metric was measured as the number of Decayed, Missing, Filled Tooth (DMFT). The net monetary benefit was then used to determine which intervention was most cost-effective.
RESULTS
The results showed that school-based caries prevention strategies are cost-effective compared to the status quo of doing nothing. The average cost per learner over the 10-year period ranged from ZAR4380 to approx. ZAR7300 for the interventions considered. The total costs (including screening) associated with the interventions and health outcome (DMFT averted) were: sugar reduction (ZAR91,380, DFMT: 63,762), APF-Gel (ZAR54 million, DMFT: 42,010), tooth brushing (ZAR72.8 million, DMFT: 74,018), fissure sealant (ZAR44.63 million, DMFT: 100,024), and ART (ZAR45 million, DMFT: 144,035). The net monetary benefits achieved for APF-Gel, sugar reduction, tooth brushing, fissure sealant and ART programs were ZAR1.56, ZAR2.45, ZAR2.78, ZAR3.81, and ZAR5.55 billion, respectively.
CONCLUSION
Based on the net monetary benefit, ART, fissure sealant and sugar-reduction appear to be the most cost-effective strategies for preventing caries in South Africa. In a resource-scarce setting such as South Africa, where there is no fluoridation of drinking water, this analysis can inform decisions about service packages for oral health.
Topics: Child; Humans; Dental Caries; Cost-Benefit Analysis; South Africa; Pit and Fissure Sealants; Dental Atraumatic Restorative Treatment; Sugars
PubMed: 37898738
DOI: 10.1186/s12903-023-03474-1 -
Dental Materials : Official Publication... Mar 2016(1) To describe caries lesions development and the role of fluoride in controlling disease progression; (2) to evaluate whether the use of fluoride-releasing pit and... (Review)
Review
OBJECTIVES
(1) To describe caries lesions development and the role of fluoride in controlling disease progression; (2) to evaluate whether the use of fluoride-releasing pit and fissure sealants, bonding orthodontic agents and restorative materials, in comparison to a non-fluoride releasing material, reduces caries incidence in children or adults, and (3) to discuss how the anti-caries properties of these materials have been evaluated in vitro and in situ.
METHODS
The search was performed on the Cochrane Database of Systematic Reviews and on Medline via Pubmed.
RESULTS
Caries is a biofilm-sugar dependent disease and as such it provokes progressive destruction of mineral structure of any dental surface - intact, sealed or restored - where biofilm remains accumulated and is regularly exposed to sugar. The mechanism of action of fluoride released from dental materials on caries is similar to that of fluoride found in dentifrices or other vehicles of fluoride delivery. Fluoride-releasing materials are unable to interfere with the formation of biofilm on dental surfaces adjacent to them or to inhibit acid production by dental biofilms. However, the fluoride released slows down the progression of caries lesions in tooth surfaces adjacent to dental materials. This effect has been clearly shown by in vitro and in situ studies but not in randomized clinical trials.
SIGNIFICANCE
The anti-caries effect of fluoride releasing materials is still not based on clinical evidence, and, in addition, it can be overwhelmed by fluoride delivered from dentifrices.
Topics: Cariostatic Agents; Dental Caries; Dental Materials; Dentin-Bonding Agents; Disease Progression; Fluorides; Humans; Pit and Fissure Sealants
PubMed: 26777115
DOI: 10.1016/j.dental.2015.12.002 -
Dental Materials : Official Publication... May 2022Dental plaque is a complex structure (called a biofilm) that is produced by a community of oral bacteria. As microorganisms accumulate in the oral cavity, bacteria can...
OBJECTIVE
Dental plaque is a complex structure (called a biofilm) that is produced by a community of oral bacteria. As microorganisms accumulate in the oral cavity, bacteria can assemble into biofilms that protect them from antibiotics and disinfectants, which contribute to dental cavities and oral infections that acts as the seed for further infections throughout the body. Therefore, there is great interest in developing dental sealants that can effectively eliminate biofilms formed from an assortment of oral bacteria species.
METHODS
In previous papers, it was shown that both in vivo and in vitro use of organo-selenium dental sealants have the potential to be an effective method for preventing dental caries and plaque formation. However, our previous in vitro study only examined the effect of the organo-selenium sealants on Streptococcus mutans and salivarius. Since that time, this organo-selenium sealant has been changed to improve its curing time.
RESULTS
We showed a selenium containing sealant (SeLECT-DefenseTM) can completely eliminate biofilm formation on the sealant at selenium concentrations of 0.25% and higher, by S. salivarius, S. sanguinis, or S. mutans, individually or in combination. This selenium containing sealant can also completely inhibit the same bacteria from growing under the sealant, while control sealant cannot. The selenium containing sealant was tested for stability and it was found to still kill these same bacteria after soaking for the equivalent of one year in PBS (pH 7.4). It was also found that the combination of the three bacteria were also killed by the selenium sealant, thus ruling out potential synergism of the bacteria in forming resistance.
SIGNIFICANCE
The following study showed that this modified selenium dental sealant effectively eliminates species of bacteria both on and under the dental sealant.
Topics: Biofilms; Dental Caries; Humans; Pit and Fissure Sealants; Selenium; Streptococcus mutans
PubMed: 35428495
DOI: 10.1016/j.dental.2022.04.006 -
European Archives of Paediatric... Dec 2022To explore the use of fissure sealing as a caries preventive method by describing characteristics of children who had received sealants and to study associations between...
PURPOSE
To explore the use of fissure sealing as a caries preventive method by describing characteristics of children who had received sealants and to study associations between sealing and caries prevalence at 12 years of age.
METHODS
The study included 3075 children examined at 5 and 12 years of age. Data were collected by clinical examination and questionnaire to parents. The questionnaire provided information on child characteristics and oral health behaviour in children at 5 years of age. Data on sealing and caries prevalence were obtained from dental records. Bi- and multivariate logistic regressions were performed. The Regional Committee for Medical Research Ethics approved the study (2.200.54 and 2013/1881).
RESULTS
Of the children, 12% had received sealants on permanent teeth before 12 years of age. Children with dentin caries at 5 years of age (OR 2.0, CI 1.5-2.7) had a higher probability of having received sealants than children without caries. Having sealants (OR 2.8, CI 2.2-3.6), enamel caries (OR 1.5, CI 1.2-1.9), dentin caries (OR 2.9, CI 2.3-3.6) and using fluoride lozenges less than daily (OR 1.5, CI 1.3-1.8) at 5 years of age were associated with having dentin caries prevalence at 12 years of age.
CONCLUSION
Few children had received fissure sealing. Although sealing was used as a caries preventive method in children who had experienced caries in primary teeth, these children continued developing caries in their permanent teeth.
Topics: Child; Humans; Pit and Fissure Sealants; Dental Caries Susceptibility; Dental Caries; Dentition, Permanent; Norway
PubMed: 35798927
DOI: 10.1007/s40368-022-00729-3