Sealants and dental caries: dentists' perspectives on evidence-based recommendations

Abstract

Background: The authors conducted a study to survey the perspectives of dentists regarding the 2010 American Dental Association (ADA) recommendation to seal non-cavitated carious lesions (NCCLs) in children and young adults.

Methods: The authors mailed a questionnaire to a randomly selected sample of 2,400 general dentists (GDs) and pediatric dentists (PDs) in the United States. The sample was chosen by the ADA's Survey Center. The questionnaire included two photographs of NCCLs (permanent first molar and premolar) in a 12-year-old child. Respondents were provided with radiographic findings and asked to choose from several management options.

Results: In the absence of radiographic evidence of caries, 37.4 percent and 42.3 percent of GDs and PDs, respectively, indicated that they would seal the NCCL in the molar. For the premolar, a significantly lower percentage of GDs than of PDs indicated that they would seal the NCCL. With radiographic evidence of caries in dentin, less than 4 percent of all dentists surveyed indicated that they would seal the NCCLs, and more than 90 percent indicated that they would remove the caries and place restorations. Less than 40 percent of dentists indicated that they sealed NCCLs in their practice.

Conclusions: The U.S. dentists surveyed have not adopted evidence-based clinical recommendations regarding the sealing of NCCLs. Practice Implications. New educational and dissemination programs should be developed regarding these evidence-based caries management approaches.