Prevalence and attitudes to fissure sealants in the general dental service in England

Abstract

Objectives. The study objectives were to investigate changes in the prevalence of fissure sealants over a 5-year period among a comparable group of 14–15-year-old regular dental attenders registered with general dental practitioners in 1989 and 1994, and to investigate attitudes towards this form of care amongst general dental practitioners in 1994. Methods. Random samples of 14–15-year-old pupils were selected from school lists in three areas in England (Doncaster, Hereford/Worcester and Wycombe) in 1989 and 1994. Once parental consent had been gained to examine the children, the Dental Practice Board (DPB) indicated which subjects were ‘regular attenders’, only these subjects were included in the study. All the subjects in each area were examined by a single trained and calibrated examiner using a standardized technique. In 1994, a group of randomly selected dentists in each area completed a telephone questionnaire assessing attitudes and treatment patterns regarding fissure sealants. Results. In 1989, 2836 letters were posted to parents asking for consent to examine their child and 2174 positive responses were received (response rate 77%). Of the 1919 children examined, 459 were classed as regular attenders, 140 in Doncaster, 159 in Hereford/Worcester and 160 in Wycombe. In 1994, 2560 consent letters were distributed to children in school to pass to their parents and 1587 positive responses were received (response rate 62%). Of the 1388 children examined, 891 were classed as regular attenders, 294 in Doncaster, 318 in Hereford/Worcester and 279 in Wycombe. Large rises in sealant prevalence were observed in all areas, but particularly in Doncaster where sealant prevalence increased from 13% in 1989 to 50% in 1994. In Hereford/Worcester it increased from 25% to 47% and in Wycombe it increased from 16% to 30%. There was also a fall in mean DMFT in all areas. In Doncaster it fell from 2·97 in 1989 to 1·82 in 1994, in Hereford/Worcester it fell from 2·60 to 1·83 and in Wycombe it fell from 1·86 to 1·29. In all three areas the changes in sealant prevalence and DMFT were statistically significant. The questionnaire revealed positive attitudes towards fissure sealants and their usage as well as a number of areas of concern that could potentially hinder sealant usage. Conclusions. Dramatic increases in sealant prevalence and considerable reductions in dental caries among these regularly attending adolescents have been demonstrated. Some concerns were highlighted regarding sealant usage, which may be prejudicing further increases in their application.