Use Of Fissure Sealants Research Articles

Impact of COVID-19 on pediatric dental care in two epicenters: Italy and Brazil.

The study aimed to compare the adherence of Brazilian and Italian pediatric dentists to the biosafety measures and operative protocols recommended by the health authorities during COVID-19 pandemic and to classify the participants according to their risk of infection. An online questionnaire with 34 questions about sociodemographic and occupational data, dental practice organization, biological risk management, and clinical operative protocols was sent to Brazilian and Italian pediatric dentists using a convenience sampling strategy. Chi-square test and multivariate analysis (two-step cluster) were performed (α = 5%). Of 641 respondents (377 Brazilians and 264 Italians), most were female (94% and 70%, respectively), aged 20-39 years (63%), with over 10 years of professional experience (58% and 49%, respectively). Based on adherence to recommended biosafety measures, participants were classified as "safer" (n = 219) or "less safe" (n = 422). Adherence to recommended protocols by the majority of participants resulted in low contagion rates (Brazilians = 5%; Italians = 12.5%). Participants with extensive professional experience in the dental setting exhibited a greater tendency to implement multiple adaptations (three or more) in their practice. Most participants (Brazilians = 92%; Italians = 80.7%) adopted the recommended minimal intervention dentistry approaches, with the use of fissure sealants and the use of non-rotary instruments for caries removal the most frequently techniques used among Brazilians (36%) and Italians (66%), respectively. Two different profiles of pediatric dentists were identified based on the biosafety protocols adopted during the pandemic. In addition, changes were implemented in the dental care provided to children, with focus on the minimal intervention dentistry.

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.

Clinical Recommendations to Improve Utilization of Fissure Sealants in Primary Healthcare Centers in Bahrain

A situation analysis among which a cross-sectional survey of dental practitioners working in primary healthcare centers found that while 127 (94.8%) out of 134 respondents consider fissure sealants effective yet, most of them have misconceptions regarding which teeth to consider carious and which to seal as only 15 (11.2%) recognized that initial carious and non-cavitated carious lesions are the same and only around half sealed either. Fissure sealants are provided for free in primary healthcare centers, but they seem underutilized as only 35 (37.6%) dentists use them very often. To address these issues and others raised by dentists and dental hygienists on the indications and the use of fissure sealants; evidence-based clinical recommendations are provided keeping in mind the high level of caries among children and adolescents in Bahrain and the services provided in primary healthcare centers. Further studies will be needed to evaluate different reasons affecting dental practitioners' knowledge and use of fissure sealants as a method of preventing and controlling caries.

Assessment of Microstructure and Release of Fluoride Ions from Selected Fissure Sealants: An In Vitro Study.

The aim of this study was to compare fluoride release from four selected fissure sealants: fissure sealant manufactured by Arkona, Helioseal F, Helioseal F Plus, and Conseal. Tested parameters included emission of fluoride ions into saline (0.9% NaCl) and deionized water over a period of 2 weeks. Values were recorded after 1, 3, 24, 48, 72, and 96 h, and then after 1 and 2 weeks. All sealants were characterized by a constant fluoride release level. The highest fluoride release level was noted for Conseal (0.0169 ppm/mg), while the lowest was noted for fissure sealant manufactured by Arkona (0.063 ppm/mg). Fissure sealants, which contain fluoride, release it not only during polymerization, but also for several days after application. The use of fissure sealants whose composition includes fluoride is an effective method of preventing tooth decay.

Fissure sealants or fluoride varnish? Routines and attitudes among dental health personnel in Norway.

To investigate routines and attitudes among dentists and dental hygienists concerning use of fissure sealants and fluoride varnish for non-operative management of occlusal caries. All dentists and dental hygienists working in child dental care in three counties in Norway were invited to answer a questionnaire on routines for use of fissure sealants and fluoride varnish. Nine statements regarding attitudes towards use of sealants were scored using a five-point Likert scale. Multivariable logistic regression analyses were performed to assess indicators associated with reported routines for use of sealants and varnish. The study was approved by the Norwegian Centre for Research Data. In total 142 of 189 (75%) dentists and dental hygienists answered the questionnaire. The majority of the respondents, n = 83 (59%), reported to prefer fissure sealants while fluoride varnish was preferred by 57 (41%) of the respondents. Frequent use of fissure sealants was reported by 58 (41%) and frequent use of varnish by 104 (74%) of the respondents. Most (n = 104, 74%), used sealants on specific indications, and 89 (64%) opened fissures only when suspecting dentine caries. Preferred method and routines for occlusal caries management differed between counties (p < 0.05). Almost all clinicians agreed with the statement that sealants are protective against caries, while statements regarding costs, technique sensitivity and children's cooperation revealed some concerns regarding fissure sealing. Fissure sealants were the preferred method for occlusal caries management despite reported concerns related to technical aspects and patient cooperation. County-level variation in frequency of sealant use was observed.

Bacterial adhesion on fissure sealants: Effects of exposure to acidic drink.

BackgroundAdherence of bacteria to teeth surface is considered an important step in the development of caries and the use of fissure sealants is crucial for the prevention of caries in occlusal surfaces of molars and premolars. The aim of this study was to investigate and compare the adherence of Streptococcus mutans to different fissure sealants, after acidic drink exposure.Material and MethodsThe tested materials were Fissurit, Fissurit FX, Grandio Seal, Fuji Triage, Constic. Bacterial suspension was deposited onto each material and the adhesion was evaluated trough the colony forming units (CFUs) determination with or without acidic drink exposure.ResultsThe tested materials showed different behaviors with significant differences. Bacterial adherence values of the untreated materials were very dissimilar: Fuji Triage and Constic materials showed the better results (P<0.05).ConclusionsSurface alteration after acidic drink exposure, changed the bacterial adhesion (except for Grandio Seal): Fissurit, Fissurit FX and Fuji Triage decreased their susceptibility to be colonized by S. mutans (P<0.05); on the contrary, Constic increased up to ~4 times the bacterial adhesiveness respected to the untreated control (P<0.05). Key words:Acidic drinks, bacterial adhesion, fissure sealants, Streptococcus mutans.

National guidelines for the use of fissure sealants in pediatric dentistry

National guidelines for the use of fissure sealants in pediatric dentistry

Guideline for the use of fissure sealants including management of the stained fissure in first permanent molars

Guideline for the use of fissure sealants including management of the stained fissure in first permanent molars

Pits and fissure sealant guidelines

The guideline aims to address four clinical questions relating to the use of pit and fissure sealants:Under what circumstances should sealants be placed to prevent caries?Does placing sealants over early (noncavitated) lesions prevent progression of the lesions?Are there conditions that favour the placement of resin-based versus glass ionomer cement sealants in terms of retention or caries prevention?Are there any techniques that could improve sealants' retention and effectiveness in caries prevention? Medline was searched for all systematic reviews on pit and fissure sealants, and the reference lists of identified reviews were searched for additional references. A second search was carried out to identify clinical studies published after the systematic review were completed. Publications were included that addressed one or more of the identified clinical questions, had a documented search strategy, and were written in English. An expert panel was convened to evaluate the evidence and develop recommendations. The draft recommendations were submitted to a wide range of scientific experts and organisations for review, following which appropriate changes were made. The evidence was classified and clinical recommendations made using a system modified from the approach taken by Shekell et al.(1) The final clinical recommendations were approved by the American Dental Association Council on Scientific Affairs. Plans were not specified for future review and updating of this guideline. Using the evidence grading and recommendation systems described by Shekelle(1) (Table 1 and 2) a number of clinical recommendations were made (see summary in Table 3). A number of topics for additional research to improve the evidence base regarding the use of fissure sealants were identified by the expert panels. These are shown in Table 2.

Study of enamel density

Objective To measure mineral concentration distributions within teeth with idiopathic enamel hypomineralisation, a condition in which developmental defects are seen in first permanent molars, and/or incisors. Design X-ray microtomographic and 3D x-ray microscopy. Setting UK University, 2001. Materials and methods X-ray microtomographic measurements of the extent of hypomineralisation in two affected molars and two contralateral controls extracted from the same patient. Results The control molars were visibly normal. The affected molars showed hypomineralised yellow opaque enamel with regions of breakdown. X-ray microtomographic images showed; a 20% reduction in mineral concentration of affected enamel (most cases involved full enamel thickness); hypomineralised enamel had a mineral concentration gradient opposite to that of normal enamel; regions of hypomineralisation distributed randomly throughout affected teeth, (apart from cervical region which was less severely affected). Conclusions The pattern of mineral concentration suggests a disturbance during the maturation process. Differences in susceptibility of the ameloblasts during different stages of dental development may explain the asymmetric distribution of the defects. Topical fluoride applications may help promote post eruption maturation of the surface layer in these teeth. The use of fissure sealants and adhesive materials appears to prevent further breakdown.

3D X-ray microscopic study of the extent of variations in enamel density in first permanent molars with idiopathic enamel hypomineralisation.

To measure mineral concentration distributions within teeth with idiopathic enamel hypomineralisation, a condition in which developmental defects are seen in first permanent molars, and/or incisors. X-ray microtomographic and 3D x-ray microscopy. UK University, 2001. X-ray microtomographic measurements of the extent of hypomineralisation in two affected molars and two contralateral controls extracted from the same patient. The control molars were visibly normal. The affected molars showed hypomineralised yellow opaque enamel with regions of breakdown. X-ray microtomographic images showed; a 20% reduction in mineral concentration of affected enamel (most cases involved full enamel thickness); hypomineralised enamel had a mineral concentration gradient opposite to that of normal enamel; regions of hypomineralisation distributed randomly throughout affected teeth, (apart from cervical region which was less severely affected). The pattern of mineral concentration suggests a disturbance during the maturation process. Differences in susceptibility of the ameloblasts during different stages of dental development may explain the asymmetric distribution of the defects. Topical fluoride applications may help promote post eruption maturation of the surface layer in these teeth. The use of fissure sealants and adhesive materials appears to prevent further breakdown.

Modern thoughts on fissure sealants.

It has long been known that fissure sealants are an important part of the prevention and control of dental caries in pits and fissures. However, their usage is still sporadic and generally not related to evidence-based guidelines. Caries prevalence has changed since sealants were introduced and this has significant implications for the criteria on which to select patients who would most benefit from their usage. The clinical technique for successful fissure sealant application is very moisture and operator sensitive. However, there is accumulating evidence that use of fissure sealants can be extended, given suitable investigation, to the early carious lesion as a 'preventive resin restoration'.

High caries levels: problems still to be tackled

According to the World Health Organization more than 60% of European countries have achieved the goal of no more than 3 DMFT at the age of 12 years. The others, including the newly independent Baltic states, still have high caries levels. Data from recent studies show that mean caries prevalence among 12-year-olds in Latvia, Lithuania, and Estonia was 5.8, 4.9, and 4.6, respectively. Absence of caries was recorded in 5% of Latvian and Estonian and 12% of Lithuanian 12-year-olds. Fifteen-year-old Latvians and Lithuanians averaged 8.1 and 7.0 DMFT, which, owing to the absence of radiographic examination, may be a substantial underestimation of real caries levels. The possible adverse effects of the privatization of dental care and the benefits of increased access to fluoride dentifrice in these countries have not yet been evaluated. The extremely poor oral hygiene seen in epidemiologic surveys indicates that fluoride dentifrices may not be widely used. The caries levels in the Baltic states resemble those commonly encountered a couple of decades ago in the Nordic countries. Data from two follow-up studies in Iceland show 66% and 52% decline in caries prevalence for 12- and 15-year-old children, respectively, over a period of 7 years. However, the caries experience of the 15-year-olds in the latter study was similar to that of 12-year-olds 10 years earlier, both in mean caries score (DMFS 11.3 and 12.1) and frequency distribution. Nor has the proportion of occlusal and approximal DF values changed in spite of frequent use of fissure sealants. While caries has become mainly a pit and fissure phenomenon in 12-year-olds, 44.3% of Swedish 19-year-olds reportedly have approximal lesions, and, when enamel lesions are recorded, approximal caries dominates the DFS scores. Analyses of trends in Nordic countries show that, despite a substantial decline in caries prevalence, vigilance is required to prevent a delayed caries development in the future adult population.

A comprehensive 30‐month preventive dental health program in a pre‐adolescent population with Down's Syndrome: A longitudinal study

A comprehensive systematic preventive dental health program was implemented in a young population with Down's Syndrome during a 30-month period. Twenty children (nine boys and 11 girls), ages 8-13 (mean age, 11), participated in the study, which took place in three hostel-like apartments. The main goals of this program were to achieve good plaque control and subsequently prevent periodontal disease as well as to apply fissure sealants and fluorides in an attempt to prevent dental caries. The mean plaque and gingival indices as well as the percentage of bleeding sites decreased significantly (P < 0.01) following the administration of our oral health program. Caries experience, as indicated by DMFS, decreased from 1-35 to 1-05 surfaces per child, and the use of fissure sealants to prevent occlusal caries was proved to be 100% effective. It is concluded that if the children's efforts are integrated with those of a motivated dentist, dental hygienist, and staff, a well-planned preventive dental health program can lead to a high degree of success in the prevention of dental diseases in young populations with Down's Syndrome.

Use of fissure sealants by dentists in private practice in Mexico City.

This paper presents findings on the use of pit and fissure sealants by dentists working in private practice in Mexico City. A total of 386 dentists participated in the study. Dentists working in high, middle, and low socioeconomic areas of the city were personally interviewed and their patients' records of the last 5 working days were reviewed. 45% of the dentists indicated that they used sealants and 10% used them during the 5 days studied. A greater proportion of recent dental graduates used sealants compared with older graduates. The dentists who utilized sealants were more likely to apply fluoride treatments in their practice than dentists who did not utilize sealants. The proportion of sealants in relation to all treatments provided was low (0.8%), and even lower in the low socioeconomic areas (0.02%). Considering the high dental caries experience of Mexican children, the use of dental sealants should be promoted by Mexico City dentists. In addition, school-based sealant programmes should be established, particularly in low socioeconomic areas.

Fissure sealants: a critique of their cost‐effectiveness

Despite the large number of clinical trials demonstrating the effectiveness of fissure sealants in preventing occlusal caries, it has been suggested that the fundamental principles of cost-effectiveness have not been applied to the use of fissure sealants and there is little in the literature which allows up-to-date judgements to be made. A review of the literature suggests that whilst the limitations in design of some of the earlier fissure sealants studies make it difficult to draw firm conclusions, the results of later studies, particularly those which evaluated fissure sealants as an integral part of routine dental care, are encouraging. A number of factors including durability and tooth selection influence the economic viability of fissure sealants. These factors must be considered and controlled if sealants are to be used cost-effectively.

Potential use of fissure sealants in the NHS.

Potential use of fissure sealants in the NHS.

Proceedings of a forum on the use of fissure sealants in public health programs. Sponsored by the Dental Health Section, American Public Health Association.

Proceedings of a forum on the use of fissure sealants in public health programs. Sponsored by the Dental Health Section, American Public Health Association.

On the use of fissure sealants in caries prevention A clinical study

The aim of the present study was to clarify in the light of a clinical investigation on 6-7 years old children, some questions concerning the use of fissure sealants in public dental care. The results of the study conducted with the Nuva-Seal R (L.D. Caulk, Milford, Del.) compound suggested a caries decrease of 84 per cent one year, and 53 per cent two years after sealant application to permanent teeth. In deciduous teeth the reduction was rather similar. Totally or partially lost sealants were not reapplied or repaired during the investigation. It is obvious that the sealants are, in most cases, apt to postpone the need of restorative treatment for a limited period of time only. Postponement may, however, be considered to achieve some advantages as compared with conventional or prophylactic filling procedures.