Introduction:
Dental caries is the most common form of oral health disease globally, with over 2.4 billion people affected, of whom 520 million children have their primary teeth demineralized. Despite the normal occurrence of an individual having dental caries, the matter should not be taken lightly, as it can affect the patient's quality of life: lower self-esteem and depression are common outcomes. The paper specifically explains how dental caries are formed in pits and fissures where plaque and bacteria typically accumulate. To combat the issue, dental sealants act as a preventative treatment that protects vulnerable tooth surfaces by creating a barrier around them.
Methods:
The paper conducted a literature review on an array of existing papers on dental sealants (2012-2022). Regarding their methodology of finding the papers, the team used keywords—“fissure sealants,” “dental sealant,” and “dental caries”—from databases such as PubMed and Scopus. Researchers narrowed down the scope of the review to 27 articles, all of which were randomized clinical trials that encompassed prevention and the utilization of sealant rates.
Results:
Overall, the literature review demonstrates the effectiveness of dental sealants in preventing the spread and demineralization of dental caries. Their role as a physical barrier—a liquid coating painted over the pits and fissures of the back teeth — prevents bacteria and food debris from entering the crevices of the tooth. Consequently, those cariogenic bacteria such as Streptococcus Mutans (S. mutans) are not able to demineralize the tooth structure by feeding on sugar to ultimately produce acid.
Some sealants, such as glass ionomer and resin sealants, have the capability of releasing fluoride ions, which helps reduce the occurrence of demineralization by strengthening the tooth’s outer surface into a more acid-resistant mineral (fluorapatite).
The paper holistically discovered a positive correlation between increased sealant usage and a decrease in dental caries. Specifically, in a 3-year randomized clinical trial, molars without any preventative care experienced a caries incidence of 98.9%, while the sealed molars had a much lower incidence of only 25.7%. In addition, another systematic review found that resin sealants had 76% lower caries risk and 85% lower caries risk after 84 months compared with no treatment.
Regarding the different sealant materials that differed throughout multiple studies, resin sealants generally had better retention rates than glass ionomer sealants, with as high as 80% versus retention rates of around 44%, respectively. However, glass ionomer sealants have their strengths, particularly when moisture control is difficult—such as with partially erupted molars.
Conclusion:
Dental sealants are an important aspect of preventive oral care as they can both prevent and reduce the further consequences of untreated dental caries. Not only can they help stop early-stage caries before surgery is needed, but they also contain a wide array of sealant types to fit with each patient’s needs. The paper displays a more nuanced side of preventive dentistry, where it is not solely limited to drilling and filling cavities.
