The relationship between the number of sound, decayed, and filled permanent tooth surfaces and the number of sealed surfaces in children and adolescents

Abstract

Objectives: The purpose of this investigation was to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces for children and adolescents from three fluoridated communities in British Columbia and to develop a predictive model of sealant use that included the dental caries status of tooth surfaces.

Methods: Children in grades 2 and 3 (n = 2,715) and adolescents in grades 8 and 9 (3,317) were surveyed to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces. The DMFS index, modified to include incipient (D1) and cavitated (D2) lesions, was used to measure the status of all tooth surfaces. The prevalence of D1D2MF and sealed tooth surfaces was estimated by age group and tooth type. Logistic regression models were developed to analyze the association between a number of independent variables and sealant use.

Results: About 60 percent of surveyed students had one or more sealants present, with a mean of 3.2 sealants per subject. Of all pit and fissure surfaces on permanent first molars, 23.4 percent and 20.1 percent were sealed for the 11 years and younger and 12 years and older age groups, respectively. For these same two age groups, the percentages of pit and fissure surfaces that were decayed and filled were 6.7 percent and 19.7 percent, respectively. For both age groups combined, 10.8 percent and 23.7 percent of all pit and fissure surfaces on second molars and premolars, respectively, were sealed. The prevalence of decayed and filled pit and fissure surfaces was 5.6 percent and 1.8 percent, respectively, for second molars and premolars. Premolars were being sealed at a rate of 13 to 1 compared to the number of decayed and filled surfaces. Logistic regression failed to identify meaningful predictors of sealant use.

Conclusions: Results from this study found an increase in the prevalence of sealants in the three communities surveyed, yet failed to identify criteria used by dentists or auxiliaries when making decisions about sealant placement. Professional education in the appropriate use of sealants may be necessary.