School-based dental sealant programmes may be effective in caries prevention

Abstract

DesignSplit-mouth randomised controlled clinical trial.InterventionSchool-based dental sealant (SBDS) programme. The study population that was selected from 67-year-old pupils of 16 elementary schools in areas of low socioeconomic status within Nice, France. Children with first permanent molar pairs sufficiently erupted for sealing with no caries (ICDAS [International Caries Detection and Assessment System] 0) or initial enamel lesions (ICDAS 1-2) were included. Children were randomised to either the intervention group (light polymerised resin-based sealant with fluoride) or the control group (no treatment).Outcome measureThe primary outcome measure was caries with sealant retention as a secondary outcome.ResultsFour hundred and fifty-seven pairs of permanent first molars belonging to 276 school children were randomised. At three years 378 pairs in 228 children were available for analysis. The overall retention rate was 32.3%. Sealed molars had 67% less risk of new carious lesions, adjusted hazard ratio = 0.33(95%CI; 0.24-0.46).ConclusionsSBDS programmes can be effective in preventing the development of carious lesions in school children, particularly those who come from low socioeconomic backgrounds and may, as a result, be unable to receive adequate oral healthcare in other settings outside the school. ICR should determine the selection of at-risk sub-groups for which the intervention could be considered.