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. 2025 May 23;25(1):768.
doi: 10.1186/s12903-025-06158-0.

Resin-based sealant effectiveness in high-caries risk children: a systematic review

Yodsapat Paemanukornruk  1 , Nicha Luksamijarulkul  1 , Piyada Gaewkhiew  2
Affiliations

Resin-based sealant effectiveness in high-caries risk children: a systematic review

Yodsapat Paemanukornruk et al. BMC Oral Health. .

Abstract

Background: There have been limited previous reviews on the use of sealants in high-caries-risk children that include multiple study designs. This systematic review aimed to evaluate the preventive effect of sealants on high-caries-risk children and compare the effectiveness of sealants between high-caries-risk children and lower-caries-risk children.

Methods: An initial protocol was developed following the PRISMA guidelines. A comprehensive literature search was performed across several electronic databases, including PubMed, the Cochrane Library, Embase and Google Scholar. Experimental or observational studies that examined resin-based sealants for preventing caries over at least 12 months in high-caries-risk children, identified by individual risk assessment, were included. Comparison groups were moderate- or low-risk children or no sealant; if unavailable, only intervention data were used. The risk of bias was assessed via the RoB2 tool and the Newcastle‒Ottawa Scale.

Results: A total of 1651 unique records were identified, 20 of which were included in this systematic review. Studies comparing only sealed teeth among different caries risk groups have indicated that high-caries-risk children have a greater risk of developing new carious lesions than low- or moderate-risk children do. In contrast, the effect of sealants was negligible in low-caries-risk children when compared between sealed and nonsealed teeth. Additionally, caries experience was the primary criterion used across all included studies.

Conclusion: Resin-based sealants are still recommended for high-caries-risk children. However, generalizability and an appropriate threshold for risk assessment remain unclear owing to the limited number of studies from low- to middle-income countries and variability in risk assessment methods.

Systematic review registration: PROSPERO Registration number CRD42023473013.

Clinical trial number: Not applicable.

Keywords: Caries; Caries risk; Children; Sealant.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

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Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Risk of bias of randomized clinical trials
Fig. 3
Fig. 3
Risk of bias of non-randomized clinical trial
See this image and copyright information in PMC

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