Objectives: The objectives of this study were to measure the caries preventive effect of sealants applied to occlusal surfaces of primary molars compared to fluoride varnish applications, and to assess the retention rate of sealants after 1 year. Methods: 147 first-grade pupils from two kindergarten schools in Kuwait, whose parents gave their written consent, were included. The children were examined by one dentist using the International Caries Detection and Assessment System. After the examination, sealants and fluoride varnish were applied on the selected occlusal surfaces of primary molars by another dentist. The jaw quadrant for intervention was selected randomly; molars on the contralateral side of the mouth received the contralateral intervention. Examinations and intervention were provided on the school premises in the mobile dental unit with a portable spotlight. Moisture was controlled by cotton rolls, suction and air drying. The follow-up examinations were conducted after 1 year. All children received fluoride varnish before and 6 months after the intervention. Results: From 267 matched pairs of occlusal surfaces of primary molars, varnished surfaces were significantly more likely to develop new caries lesions than the sealed ones (odds ratio = 2.92; 95% confidence interval = 1.82-4.71) during the 1-year follow-up. The majority (73.0%) of the sealants were completely retained and 15.1% partially. Conclusions: Sealing fissures seems to be better in preventing occlusal caries lesions in primary molars than applying only fluoride varnish. After 1 year, the majority of sealants were retained sound.

Keywords:
Dental sealants, Fluoride varnish, International Caries Detection and Assessment System, Occlusal surface, Primary molars
1.
Ahovuo-Saloranta A, Forss H, Walsh T, Hiiri A, Nordblad A, Mäkelä M, Worthington HV: Sealants for preventing dental decay in the permanent teeth. Cochrane Database Syst Rev 2013;3:CD001830.
2.
Al-Mutawa SA, Shyama M, Al-Duwairi Y, Soparkar P: Dental caries experience of Kuwaiti schoolchildren. Community Dent Health 2006;23:31-36.
3.
Al-Mutawa SA, Shyama M, Al-Duwairi Y, Soparkar P: Dental caries experience of Kuwaiti kindergarten schoolchildren. Community Dent Health 2010;27:213-217.
4.
Ariga J, Al-Mutawa S, Nazar H: School oral health program in Kuwait. Med Princ Pract 2014;23:99-111.
5.
Behbehani JM, Scheutz F: Oral health in Kuwait. Int Dent J 2004;54:401-408.
6.
Bravo M, Baca P, Llodra JC, Osorio E: A 24-month study comparing sealant and fluoride varnish in caries reduction on different permanent first molar surfaces. J Public Health Dent 1997a;57:184-186.
7.
Bravo M, García-Anllo I, Baca P, Llodra JC: A 48-month survival analysis comparing sealant (Delton) with fluoride varnish (Duraphat) in 6- to 8-year-old children. Community Dent Oral Epidemiol 1997b;25:247-250.
8.
Bravo M, Montero J, Bravo JJ, Baca P, Llodra JC: Sealant and fluoride varnish in caries: a randomized trial. J Dent Res 2005;84:1138-1143.
9.
Francis R, Mascarenhas AK, Soparkar P, Al-Mutawa S: Retention and effectiveness of fissure sealants in Kuwaiti school children. Community Dent Health 2008;25:211-215.
10.
Hardison JR, Collier DR, Sprouse LW, Van Cleave ML, Hogan AD: Retention of pit and fissure sealant on the primary molars of 3- and 4-year-old children after 1 year. J Am Dent Assoc 1987;114:613-615.
11.
Hayes RJ, Bennett S: Simple sample size calculation for cluster-randomized trials. Int J Epidemiol 1999;28:319-326.
12.
Hiiri H, Ahovuo-Saloranta A, Nordblad A, Mäkelä M: Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents. Cochrane Database Syst Rev 2010;3:CD003067.
13.
Hotuman E, Rølling I, Poulsen S: Fissure sealants in a group of 3-4-year-old children. Int J Paediatr Dent 1998;8:159-160.
14.
Hujoel PP, DeRouen TA. Validity issues in split-mouth trials. J Clin Periodontol 1992;19:625-627.
15.
Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB: The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 2007;35:170-178.
16.
Mickenautsch S, Yengopal V: Validity of sealant retention as surrogate for caries prevention - a systematic review. PLoS One 2013;8:e77103.
17.
Nazar H, Al-Mutawa S, Ariga J, Soparkar P, Mascarenhas AK: Caries prevalence, oral hygiene, and oral health habits of Kuwaiti infants and toddlers. Med Princ Pract 2014;23:125-128.
18.
Northway WM, Wainright RL, Demirjian A: Effects of premature loss of deciduous molars. I. Changes in posterior arch dimensions. II. Source of space change. III. Age at exfoliation and its influence on rate of space change. V. Role of occlusion in tooth migration. VI. Models of space closure. Angle Orthod 1984;54:295-329.
19.
Oliveira BH, Salazar M, Carvalho DM, Falcão A, Campos K, Nadanovsky P: Biannual fluoride varnish applications and caries incidence in preschoolers: a 24-month follow-up randomized placebo-controlled clinical trial. Caries Res 2014;48:228-236.
20.
Poulsen S, Peltoniemi A-L: Retention of fissure sealant in primary second molars after 6 months. Scand J Dent Res 1979;87:328-330.
21.
Seward FS: Natural closure of the deciduous molar extraction spaces. Angle Orthod 1965;35:85-94.
22.
Simonsen RJ: Retention and effectiveness of dental sealants after 15 years. J Am Dent Assoc 1991;122:34-42.
23.
Shoaib L, Deery C, Ricketts DNJ, Nugent ZJ: Validity and reproducibility of ICDAS II in primary teeth. Caries Res 2009;43:442-448.
24.
Splieth C, Förster M, Meyer G: Additional caries protection by sealing permanent first molars compared to fluoride varnish applications in children with low caries prevalence: 2-year results. Eur J Paediatr Dent 2001;3:133-138.
25.
Sköld-Larsson K, Modéer T, Twetman S: Fluoride concentration in plaque in adolescents after topical application of different fluoride varnishes. Clin Oral Invest 2000;4:31-34.
26.
Tinanoff N, Douglass J: Clinical decision-making for caries management in primary teeth. J Dent Educ 2001;65:1133-1142.
27.
Vigild M, Skougaard M, Hadi RA, Al Za'abi F, Al-Yasseen I: Dental caries and dental fluorosis among 4-, 6-, 12-, and 15-year-old children in kindergartens and public schools in Kuwait. Community Dent Health 1996;13:47-50.
28.
Wendt LK, Koch G, Birkhed D: On the retention and effectiveness of fissure sealant in permanent molars after 15-20 years: a cohort study. Community Dent Oral Epidemiol 2001;29:302-307.
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2015
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