Fissure Sealants Research Articles

Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study.

The preventive benefits of pit and fissure sealants rely on their retention and sealing ability. The drawback of the conventional pit and fissure sealant is its poor retention due to the presence of moisture. Among the numerous pit and fissure sealants available, newer hydrophilic sealants are ideal for children. This study evaluates and compares the sealing ability of hydrophilic sealant Embrace WetBond with conventionally used glass ionomer sealant under a stereomicroscope. A total of 48 extracted human premolars were randomly divided into two groups (N = 24) and sealed with Embrace WetBond and GC Fuji VII as per manufacturers' instructions. Following thermocycling, the sectioned samples were evaluated for sealant penetration, unfilled space, and total length of fissure under a stereomicroscope at magnifications 2.5×, 4×, and 5×. The values were measured in microns and in various fissure types using the "ImageJ app" to measure the sealant penetrability and sealing ability. The data recorded were statistically evaluated. The penetrability of moisture-tolerant sealant was better (87.8 ± 10.7) compared to that of glass ionomer sealant (73.8 ± 15.5) (p = 0.002). Among the samples, U-type fissure patterns displayed greater penetrability (94.2 ± 6.2), whereas IK-type fissures revealed the lowest degree of penetrability (67.5 ± 7.3). Embrace WetBond is better than glass ionomer sealant with respect to penetrability and sealing ability under stereomicroscope hence recommended as a better sealant for pediatric clinical practice. Priscilla S, Shivashankarappa PG, Mohandoss S, et al. Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S67-S71.

Households' Willingness to Pay for Receiving Preventive and Therapeutic Dental Services: The Double- Bounded Dichotomous Choice Approach

Background: Understanding the value and willingness to pay (WTP) for services is crucial for decision- making. Objectives: This study aimed to measure the level and factors affecting households’ WTP for dental services using the double- bounded dichotomous choice approach. Methods: This cross- sectional study collected data through a questionnaire- based interview with 300 households in the city of Tabriz, Iran, in 2019. The double- bounded dichotomous choice approach was used to estimate WTP, and factors related to WTP were calculated using an internal regression model, and data were analyzed using Stata 14. Results: The households’ mean WTP for fissure sealant, fluoride therapy, scaling, and removable orthodontics were $8.96, $4.36, $16.00, and $47.38, respectively. Household income, education level, age, regular dental visits, and having elderly people in the family were found to be factors affecting WTP for dental services. Conclusions: The study found that household income was a significant factor affecting WTP for dental services. Not using dental services is often due to low household income and high service prices. Therefore, policymakers should consider setting dental service prices based on income levels to ensure access to services for all income groups.

Clinical Evaluation and Microleakage of Fissure Sealant: Effect of Laser Etching vs Acid Etching

Aim: The aim of this study was to evaluate the clinical success and the sealing ability of a resin based fissure sealant that applied enamel surface which was etched with conventional phosphoric acid and Er:YAG laser at different energy levels. Material and Methods: The study consisted of two parts; the evaluation of retention, marginal discoloration, marginal integrity and new caries formation for the clinical success after the treatment at 3, 6, 12 months; the evaluation of microleakage and penetration depth to fissures using dye penetration test. The in vivo part of the study was the surface preparation processes, 72 teeth in each group; It consists of 32% phosphoric Acid, Er:YAG laser- MSP (Medium Short Pulse) and Er:YAG laser- QSP (Quantum Square Pulse). A total of 45 impacted human third molar teeth were used for in vitro part. Data were analyzed using SPSS 21. Results: The relationship between the success rates of 12-month clinical follow-up of fissure sealants and age, gender, and localization was assessed and there was no statistically significant correlation. When all criteria were considered, the most successful group was QSP. All the groups demonstrated microleakage regardless of the surface preparation techniques. However, there was no statistically significant difference between the groups. Conclusion: It is considered to determine the optimal energy level of laser will increase the clinical success.

Evaluation of Retention and Sealing Ability of Pit and Fissure Sealant Using Stereomicroscope with and without SDF/KI Pretreatment: In Vitro Study

Evaluation of Retention and Sealing Ability of Pit and Fissure Sealant Using Stereomicroscope with and without SDF/KI Pretreatment: In Vitro Study

Pattern of Tooth Extraction and Use of Space Maintainers in Paediatric Dental Patients in Lagos State University Teaching Hospital, Ikeja

The primary dentition is essential in the maintenance of normal occlusion in the permanent dentition. Both dentitions enhance aesthetic, speech and are functional in nature. Early loss of the primary dentition necessitates the placement of space maintainers. This study determined the pattern of tooth extraction of patients attending the paediatric dental clinic in Lagos State University Teaching Hospital, Ikeja and the use of space maintainers. A retrospective study carried out using the dental records of patients who attended the Paediatric dental clinic, Lagos State University Teaching Hospital, Ikeja, Lagos. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 20 (IBM, New York). The prevalence of tooth extraction was 49.8% among a population of 410 subjects with a total of 353 extracted teeth. The male to female ratio was 1:1.37. Majority (58.3%) of the subjects had only one tooth extracted. The commonest reason for extraction was retained primary teeth (35.8%). The commonest arch and segment of extraction was the mandible (56.1%) and the anterior teeth (51.0%). The commonest tooth extracted was upper right primary central incisor (7.6%). The most common space maintainer was band and loop. Retained teeth was the most common reason for tooth extraction followed by sequelae of dental caries, caries and trauma. This highlights the need for implementation of oral health prevention policies with regards to the use of fluoride, fissure sealants, silver diamine fluoride increased awareness of safety protocols to mitigate traumatic injuries and introduction of dental health education programs in schools and community.

Effects of topical fluoride treatment on the bond strength of pit and fissure sealants: A systematic review.

This systematic review aimed to evaluate the available scientific evidence concerning the effects of topical fluoride treatment on the bond strength of pit and fissure sealants. Prevention of dental caries is one of the crucial issues in pediatric dentistry. Pit and fissure sealant and fluoride therapies are two caries prevention procedures that may be performed in one session. However, fluoride therapy may affect the bond strength of pit and fissure sealants. An electronic search for in vitro studies published in English and Persian on topical fluoride therapy and the bond strength of pit and fissure sealants was performed via PubMed/ Medline, Web of Science, Google Scholar, Embase, and Scopus databases until May 2022. The articles were independently reviewed for quality by two reviewers. Textual data were analyzed manually, and the bond strength of sealants placed after fluoride application was compared with control groups. A total of 8482 articles were initially identified and reviewed by two independent reviewers, and 13 were selected for full-text evaluation. Finally, six articles were included in the systematic review. A total of 250 teeth were studied, 148 of which were in the case group (fluoride group) and 102 in the control group. Tensile and shear bond strengths were compared between groups in the studies. In the studies in which the tooth surfaces were washed after applying fluoride, there was no change in the fissure sealant bond strength. However, in studies in which fluoride was not washed, the bond strength decreased significantly, independent of the fluoride type.

Expert consensus on relevant topics for undergraduate paediatric dental curriculum using the fuzzy Delphi method: a new direction for Malaysian dental education

BackgroundPaediatric dentistry is a branch of dental specialty that focuses on dental care for children from infancy through adolescence. However, there is no standardised national undergraduate paediatric dental curriculum in Malaysia. The present study aimed to identify relevant topics for undergraduate paediatric dental curricula and to determine the appropriate cognitive and psychomotor levels for each topic based on the consensus among paediatric dental experts.MethodsPotential relevant undergraduate paediatric dentistry topics were initially drafted and revised according to the revised national competency statement. The final draft included 65 topics clustered under 18 domains. A fuzzy Delphi method was used and experts who fulfilled the inclusion criteria were invited to anonymously ranked the importance of relevant topics using a five-point Likert scale and proposed suitable cognitive and psychomotor levels for each topic. Fuzzy evaluation was then performed, and experts were considered to have reached a consensus if the following three conditions were achieved: (a). the difference between the average and expert rating data was ≤ 0.2; (b). the average expert consensus was ˃70%; and (c). the average fuzzy number was ≥ 0.5. Subsequently, the mean ratings were used to determine the cognitive and psychomotor levels.Results20 experts participated in the survey. 64 out of 65 paediatric dentistry topics were deemed acceptable. The average fuzzy number ranged from 0.36 to 0.85, while the average Likert score ranged from 3.05 to 5.00. The topic “Dental amalgam” was rejected based on expert consensus since the average fuzzy number was 0.36. The most significant topic was “Pit and fissure sealant”, followed by “Preventive advice”, “Early childhood caries”, “Dental caries in children & adolescent”, “Management of dental caries in paediatric patients”, and “Consent” which were equally ranked as the second most important topics. According to Bloom’s and Simpson’s taxonomies, most of the paediatric dentistry topics were rated adequate for undergraduate students at the cognitive level of “Apply” (C3) and a psychomotor level of “Guided response” (P3).ConclusionThe current study successfully identified relevant undergraduate paediatric dentistry topics using the fuzzy Delphi method, which can facilitate future educators to improve existing Malaysian undergraduate paediatric dental curricula.

An In vitro Assessment of the Shear Bond Strength of Two Different Pit and Fissure Sealants in Primary Teeth.

The current research had an aim to evaluate the shear bond strength of two different pit and fissure sealants in deciduous teeth. Forty deciduous teeth were part of this research. Inclusion criteria were teeth having an unbroken occlusal surface, whereas samples having developmental defects/afflicted with caries were subjected to exclusion from this research. Each specimen tooth was assigned at random to one of the two groups constituting 20 specimens each by means of a computer-generated randomization with two alphabets (A, B). Group 1: Conventional sealant, Group 2: Self-adhering flowable sealant. Following sealant coating, a shear load was placed via a universal testing apparatus in a manner parallel to the bonded edge at a speed of 0.5 millimeter/minute till the occurrence of a breakdown. Bond strength was subsequently measured in Mega Pascals (MPa). 13.86 ± 0.23 was the mean shear bond strength of self-adhering flowable sealant versus 11.48 ± 0.52 Mpa of conventional sealants. Statistically significant differences amid both groups were noted. The current research arrived at a conclusion that self-adhering flowable sealants exhibited superior shear bond strength in comparison to conventional sealants.

MID (Minimal Intervention Dentistry) by Pediatric Dentist Specialist in City of Surabaya during the COVID-19 Pandemic


 Introduction: COVID-19 pandemic that has occurred worldwide due to the rapid spread of the SARS-CoV-2 virus requires adaptation, including in dentistry. Changes in dental care services have occurred in Indonesia, including closing practices, using PPE up to level 4, types of procedures that can be given, duration of treatment, and criteria for pediatric patients companion. Minimal Intervention Dentistry (MID) is defined as a principle in dentistry that aims to maintain oral tissue and prevent the development of a more severe disease. This technique is child-friendly because it does not involve various dental instruments that tend to increase anxiety. MID also produces small amounts of aerosols resulting minimal spread of COVID-19. Objective: This study aims to raise awareness about the application of MID by pediatric dentists specialist in the city of Surabaya during the COVID-19 pandemic. Methods: The study utilized a questionnaire as the primary research instrument to gather data from a sample of 33 respondents out of a population of 60 pediatric dentists in Surabaya. The questionnaire covered various aspects, including the location and type of practice, years of practice, experience with practice closures, and data on actions taken by respondents regarding the implementation of MID measures during the pandemic. Results: Pediatric dentistry during the COVID-19 pandemic experienced a series of changes in its implementation, including closing practices for a period of several days, weeks and months, in 18.87%, 24.53%, 56.6% respectively. MID procedures have been widely used by pediatric dentists since before pandemic (80%) are fissure sealants with HVGIC ingredients (80%), Preventive Resin Restoration (82.8%), GIC restorations (83.9%), and SSC Hall Technique (77.3%). There were variations in the number of MID procedures performed by pediatric dentists the city of Surabaya during the COVID-19 pandemic, some of which had increased (26.67%), decreased (33.33%) and remained constant (40%). Conclusion: The implementation of the MID advantages in pediatric dentistry is very useful and has been applied before and during the COVID-19 pandemic and is recommended for future use.

Evaluating Skills and Confidence Status of House Officers in Managing Dental Patients: A Mixed Method Study in a Private Dental Institute of Karachi

Objective: To evaluate the skills and confidence status of house officers in managing dental patients.
 Study Design: Mixed method (Sequential-explanatory) study.
 Place and Duration of Study: Altamash Institute of Dental Medicine, Karachi Pakistan, from Mar 2019 to Mar 2020.
 Methodology: A self-administered questionnaire was developed for the 1st phase of the study. After validation from the content experts, a pilot test was run on 18 house officers before administering the questionnaire. It included 46 dental procedures; participants rated their skills and confidence in performing them using a Likert scale of 1 to 5 points ranging from poor to excellent. In the 2nd phase, sixteen face-to-face interviews were conducted to explain the reasons for acquiring skills and confidence status.
 Results: The response rate was 100%. Fifty-eight house officers filled out the questionnaire. Participants with multiple rotations reported significantly above average confidence status with multiple rotations of retainer insertion (81%), treatment of malocclusion using removable appliances (82%), fissure sealants (78%), anterior endodontic (80%), posterior amalgam (69%), oral hygiene (69%), and diagnosis of caries (67%), TMJ disorders (69%), rubber dam placement (71%) and properly prescribed recommended medicine (65%) when compared to the single rotation. The most important high-confidence status themes in evaluating skills were practising the procedures and internal motivation.
 Conclusion: Multiple rotations with repeated practice sessions enhanced house officers' skills and confidence status.Procedures that were least practised scored the lowest in overall mean confidence.Keywords: Confidence status, Curriculum, Dental graduates, Dental procedures, Evaluation, House officers, Skills.

Real-world effectiveness of national pit and fissure sealants program in Taiwan

ObjectivesThis study investigated the effectiveness of a national population-based pit and fissure sealants (PFS) program in Taiwan. MethodsPart 1 (effectiveness of national PFS program) involved children who had participated in the PFS program from 2015 to 2019. After propensity score matching, 670,840 children were selected for analysis until the end of 2019. During follow-up, the permanent first molars of the participants were assessed for caries-related treatments by employing multilevel Cox proportional hazards models. In Part 2 (effectiveness of retained sealants), which involved 1,561 children, sealant retention was evaluated 3 years after placement. A structured questionnaire was employed to collect information on family and individual factors. The endpoints were the same as in Part 1. ResultsIn Part 1, the adjusted hazard ratios (HRs) for caries-related treatments among participants in the PFS program were 0.90 (95% confidence interval [CI] = 0.89, 0.91) for dental restoration, 0.42 (95% CI = 0.38, 0.46) for initiation of endodontic treatment, 0.46 (95% CI = 0.41, 0.52) for completion of endodontic treatment, and 0.25 (95% CI = 0.18, 0.34, all Ps < 0.0001) for extraction. In Part 2, the adjusted HR for dental restoration of teeth with retained sealants was 0.70 (95% CI = 0.58, 0.85), significantly lower than that for teeth without retained sealants (P = 0.0002). ConclusionsParticipation in the national PFS program was associated with a significant reduction of at least 10% in the risk of caries-related treatments, and an additional 30% risk reduction may have been attributed to sealant retention. Clinical SignificanceIn a real-world setting, schoolchildren in the national PFS program were associated with a significant reduction of at least 10% in the likelihood of caries-related treatments. The program provided moderate protection against caries for the study population and could be improved by increasing the sealant retention rate.

Indications, techniques, and outcomes of pit and fissure sealants in pediatric dentistry

Pit and fissure sealants are safe and effective preventive measures for reducing the risk of tooth decay in pediatric patients. The procedure for applying sealants is a relatively quick and non-invasive process that typically involves preparation, isolation, and etchant application. They are typically used on the occlusal surfaces of molars and premolars, which have deep grooves and fissures that are difficult to clean. Sealants are mostly applied to the permanent molars in children, as they are the most susceptible to decay due to their deep grooves and pits sealants are non-invasive, cost-effective, easy to apply, and long-lasting. However, sealants cannot be used on teeth with existing decay, and they may need to be reapplied periodically to ensure continued protection. Sealants are not a substitute for good oral hygiene habits, regular dental check-ups, and cleanings. The necessity of the preventive dental procedure is based on the child's individual needs and the condition of their teeth.

Preparation and Characterization of Dental Pit and Fissure Sealant Based on Calcium Sodium Silicate Bioactive Glasses

This study aimed to prepare a resin based dental sealant loaded with novel bioactive glass formulated from (50 wt% calcium silicate and 50 wt% sodium silicate) with different percentages of fluorapatite. Four glass batches were formulated then characterized using Fourier Transform Infrared Spectroscopy analysis, X-ray powder diffraction analysis and Transmission electron microscopy. Density, microhardness and bioactivity testing after insertion in artificial saliva were done. Four bisphenol A-glycidyl methacrylate (Bis-GMA) based sealants loaded with the glass batch that showed the preeminent properties and silica fillers were prepared. The prepared sealants were compared to commercial sealants regarding flow, curing depth, compressive strength and microhardness. Sealant composition that showed comparable properties to that of the commercial sealant was selected for pH changes and ion release testing after immersion in artificial saliva for different time intervals. Results indicated amorphous nature, bioactive behavior and apatite forming ability of the tested glass batches. Experimental sealant revealed comparable tested properties with lower compressive strength compared to the commercial sealants at P < 0.001. The mean pH values of the tested sealants ranged from 6.75 to 6.35 with extended calcium and phosphorus ion release up to 90 days. It was concluded that the 85 wt% calcium silicate and sodium silicate with 15 wt% fluorapatite had the best trend regarding ion release and apatite forming ability. Sealant loaded with 65 wt% bioactive glass, 10 wt% sintered nanosilica and 10 wt% nanosilica had the best acceptable mechanical properties. The novel pit and fissure sealant is a promising bioactive and ion releasing material.

Methods of Primary Clinical Prevention of Dental Caries in the Adult Patient: An Integrative Review.

Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels. This review followed the PICO strategy with the research question: "What are the methods of primary prevention of dental caries, in adults, for improving and maintaining oral health integrating clinical and community-based strategies?" Electronic screening was carried out by two independent reviewers in five databases (MedLine/PubMed, SciELO, Web of Science, Cochrane Library, and LILACS) to find relevant publications between 2015-2022. We applied eligibility criteria for selection of the articles. The following MeSH terms were used: "Primary Prevention"; "Adult"; "Oral Health"; "Dental Caries"; "Fluorides, Topical"; "Fluoride Varnishes"; "Pit and Fissure Sealants"; "Preventive Dentistry". Although the term "Prevention strategy" is not a MeSH descriptor, several correlated terms appeared and were used in the search engines: "Preventative Care", "Disease Prevention, Primary", and "Prevention, Primary". The tool provided by the JBI organization (Joanna Briggs Institute) was used to assess the quality of the included studies. Nine studies were included. Overall, it was found that the main primary prevention methods applied in dentistry in adults are the application of pit and fissure sealants, topical application of fluoride performed in the dental clinic, use of fluoridated toothpaste, mouthwash with chlorhexidine at home, use of xylitol, the recommendation for regular appointments with the dentist, and the need to inform patients about the saliva buffer capacity and adoption of a non-cariogenic diet. For that purpose, preventive policies should be taken to prevent dental caries. These include three major challenges: providing the adult population with more knowledge regarding their oral health, empowering patients through adopting healthy lifestyles, and developing new preventive strategies and awareness campaigns aimed at the adult population to promote proper oral health habits. A small number of studies were found whose participants were adult patients. There was some consistency regarding primary prevention methods in our studies. However, good quality randomized control studies are still required to define the best intervention strategies for adult caries prevention.

The F word revisited

Dental UpdateVol. 50, No. 6 CommentThe F word revisitedFJ Trevor BurkeFJ Trevor BurkeSearch for more papers by this authorFJ Trevor BurkePublished Online:13 Jun 2023https://doi.org/10.12968/denu.2023.50.6.473AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article References National Institute of Dental and Craniofacial Research. The story of fluoridation. Available at: https://tinyurl.com/uw36c6v5 (accessed May 2023). Google ScholarRandall RC, Wilson NH. Glass-ionomer restoratives: a systematic review of a secondary caries treatment effect. J Dent Res 1999; 78: 628–637. https://doi.org/10.1177/00220345990780020101 Medline, Google ScholarWiegand A, Buchalla W, Attin T. Review on fluoride-releasing restorative materials – fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dent Mater 2007; 23: 343–362. https://doi.org/10.1016/j.dental.2006.01.022 Medline, Google ScholarYengopal V, Mickenautsch S, Bezerra AC, Leal SC. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta analysis. J Oral Sci 2009; 51: 373–382. https://doi.org/10.2334/josnusd.51.373 Medline, Google Scholar FiguresReferencesRelatedDetails 2 June 2023Volume 50Issue 6ISSN (print): 0305-5000ISSN (online): 2515-589X Metrics History Published online 13 June 2023 Published in print 2 June 2023 Information© MA Dentistry Media LimitedPDF download

Application Study of Novel Eggshell/Ag Combined with Pit and Fissure Sealants.

The study aims to enhance the anti-caries performance of pit and fissure sealants through the synthesis of novel silver nanocomposites, and to evaluate their mechanical properties and biological safety in vitro and in vivo. The antibacterial properties of synthetic eggshell/Ag were detected by bacterial inhibition zone, minimum bacteriostatic concentration, fluorescence staining and scanning electron microscopy. The synthetic products were then combined with pit and fissure sealants to prepare specimens, and their effects on mechanical properties, antibacterial properties and cytotoxicity were evaluated. Furthermore, an oral mucosal contact model of golden hamsters was established according to the ISO10933 standard to evaluate local stimulation and systemic effects. The novel nanocomposite eggshell/Ag was confirmed to exhibit strong broad-spectrum antibacterial activity, and that the eggshell/Ag-modified pit and fissure sealant had strong antibacterial properties against common dental caries bacterial biofilms, without any significant change in mechanical properties. The gradient dilution extract showed acceptable cytotoxicity, and in the golden hamster oral contact model, there were no visible abnormalities in local mucosal tissues, blood indices, or liver and kidney histopathology. These findings suggest that eggshell/Ag combined with pit and fissure sealants has strong antibacterial activity and excellent biosafety in vitro and in vivo, making it a promising candidate for clinical applications.

Vincristine, doxorubicin and cyclophosphamide chemotherapy induced oral chronic hyperplastic candidiasis and xerostomia in a young patient with Ewing’s sarcoma: A case report

Abstract A common primary bone malignancy in childhood and adolescence is Ewing’s sarcoma. Here we report multidisciplinary approach in the management of chronic hyperplastic candidiasis and xerostomia secondary to chemotherapy with vincristine, doxorubicin and cyclophosphamide (VDC) in a pediatric male patient with Ewing’s sarcoma of Ethmoid sinus. The initial diagnosed oral lesion was treated with topical clotrimazole 1%w/v for two weeks and Sucralfate 1g/10mL oral rinse for one month. Upon subsequent VDC chemotherapy cycle, the patient developed grade IV oral mucositis, severe neutropenia and associated oesophageal candidiasis. Treatment included combination of topical clotrimazole 1%w/v and Fluconazole 300mg/day (IV for 5 days and Tablet for 14 days). To prevent caries risk, pit and fissure sealants were applied and topical fluoride therapy was given; patient was encouraged to have frequent sips of water and prescribed kids xylitol gum for 15 days to minimize xerostomia. At 5-week follow up, reduction in burning sensation and resolution of white lesion was noted.

Sealant penetration of Resin-based Pit and Fissure Sealant Pretreated with Er, Cr: YSSG Laser

Sealant penetration of Resin-based Pit and Fissure Sealant Pretreated with Er, Cr: YSSG Laser

Barriers to prevention in oral health care for english NHS dental patients: a qualitative study of views from key stakeholders

BackgroundDespite significant progress in the control of oral diseases since the discovery of fluoride in the 1940s, dental caries and periodontal diseases continue to affect a significant proportion of the population, particularly socially disadvantaged and lower socioeconomic groups. The National Health Service in England provides preventive advice and treatments as part of an oral health assessment, and evidence-based guidance recommends the use of fissure sealants and topical fluorides in addition to dietary and oral hygiene advice. Although oral health promotion and education have become expected parts of dental care, the need for restorative treatments remains relatively high. We aimed to explore how barriers to preventive advice and treatment for NHS patients may be hindering the provision of prevention in oral health to patients from the perspectives of multiple key stakeholders.MethodsSemi-structured interviews and focus groups were undertaken between March 2016-February 2017 with four groups of stakeholders: dentists, insurers, policy makers and patient participants. The interviews were analysed using deductive, reflexive thematic analysis.ResultsThirty-two stakeholders participated: 6 dentists, 5 insurers, 10 policy makers, and 11 patient participants. Four themes were developed: Perspectives on the clarity of oral health messaging and patient’s knowledge, The variability of prioritising prevention, Influences of the dentist-patient relationship on effective communication and Motivation to enact positive oral health behaviours.ConclusionsThe findings from this research indicate that patients’ knowledge of and priority placed on prevention is variable. Participants believed that more targeted education could be valuable in enhancing these. A patient’s relationship with their dentist could also influence their level of knowledge through the information shared with them, their receptivity to the preventive messages and the value they place on it. However, even with knowledge, prioritising prevention and a good patient-dentist relationship, without motivation to engage in preventive behaviour the impact of these is reduced. Our findings are discussed in relation to the COM-B model of behaviour change.

Dental caries prediction and the indication of pit and fissure sealant in children first permanent molars: A prospective study

ObjectivesTo evaluate predictors for caries incidence on first permanent molars and to assess the accuracy and efficiency of these predictors for the indication of pit and fissure sealants. Methods: This 7-y cohort study started in 2010 with a sample of 639 children (1–5 years) from Southern Brazil. Dental caries was assessed using the ICDAS. Maternal education, family income, parental perception on child oral health and severe dental caries experience were collected at baseline and used to test the prediction of dental caries. Predictive values, accuracy and efficiency were estimated for each possible predictor. Results449 children were re-assessed at follow-up (70.3% retention rate). The baseline characteristics showed similar risks for dental caries incidence in first permanent molars. Low family income and poor parental perception of child oral health were moderately accurate in correctly identifying sound children who would not need to receive pit and fissure sealant. However, all the adopted criteria have lower accuracy incorrectly identifying children who later developed dental caries in first permanent molars. ConclusionsDistal and intermediate factors were relatively accurate in determining caries risk incidence on children's first permanent molars. The criteria adopted were more accurate in identifying sound children than those who need to receive pit and fissure sealant. Clinical relevanceOur findings reinforce the idea that investing in strategies that take into account common risk factors still represents the best option for dental caries prevention. However, adopting only these parameters is not enough to indicate pit and fissure sealants.