Fissure sealants and fluoride varnish applications are effective measures for caries prevention on occlusal surfaces. For several years, there were only a limited number of clinical studies, mostly with only a few children, in which the effectiveness of the two measures was compared. In these studies as well as in related reviews and meta-analyses the sealants consistently performed better. A newer clinical study from Wales showed some time ago that the caries inhibition can be statistically the same for both measures. This study is now part of recent reviews or updates of meta-analyses. In these meta-analyses, the superiority of fissure sealing with regard to caries inhibition in molars compared to fluoride varnish application is no longer determined. Despite this changed situation, however, there is no reason for our health care system to deviate from sealing as an individual preventive measure. This conclusion results from open questions and inadequacies of the recent reviews, which are directly addressed in these. In clinical use, the combination of sealants and regular fluoride varnish applications seems to provide great caries-preventive benefit.