Comparison of dental health in sealed and non-sealed first permanent molars: 7 years follow-up in practice-based dentistry

Objectives The use of digital dental records enables the retrospective analysis of the effectiveness of the fissure sealants applied in everyday dental practice. We tested the hypothesis that sealant treatment of first permanent molars results in a diminished need for restorative treatment in sealant treated teeth compared to their non-sealed counterpairs tested in a “practice-based research” (PBR) protocol. Methods Kaplan–Meier survival analysis was used to estimate the survival of first permanent molars caries-free, either sealed or non-sealed, for children attending two health centers in Finland (Kemi and Vantaa). Results Non-sealed teeth were restored approximately 50% more frequently compared to their sealed counterparts in Vantaa. In Kemi, however the survival of non-sealed teeth was even greater compared to sealed teeth. This was thought to be due to successful targeting of selective sealant treatment to real high caries risk teeth in Kemi whereas in Vantaa the strategy was to seal all molars routinely. Conclusions The results suggest that the use of fissure sealant treatment routinely, without caries risk determination, is not the treatment of choice in preventing dental restorations but it effectively reduces caries rates in real-life conditions.