ABSTRACT
The aim of this review is to give an overview of 50 years experience of fissure sealing and draw conclusions about the applicability and effectiveness of the method. Another purpose is to provide a summary of the relevant scientific evidence that will assist clinicians with their decision-making process. A fissure sealant is a material that is placed in the pits and fissures of teeth in order to prevent the development and/or to arrest of initial caries progression. Sealants, by providing a physical barrier, inhibit microorganisms and food particles from collecting in pits and fissures. Sealants are highly effective in preventing dental caries in pits and fissures of teeth when applied by trained operators. Sealant should be placed on pits and fissures of children's and adolescents' permanent teeth when it is determined that the tooth or the patient is at risk of developing caries. Fissure sealing can be recommended as a caries preventive measure. Whilst there is a good evidence to support the inclusion of fissure sealants as part of a preventive programme from the dental team, a number of related issues need to be considered. In areas of high caries prevalence it has been shown that treatment costs can actually be reduced by sealing susceptible surfaces, usually the occlusal surfaces of first permanent molars. Fissure sealing was introduced and first investigated in the years 1960-1970. During the past decades, evidence-based approaches have developed concerning the effectiveness of this primary and secondary preventive measure. It is generally accepted that the effectiveness of sealants for caries prevention depends on long-term retention. Resin-based sealants are the first choice of material for dental sealants. Glass-ionomer cement may be used as an interim preventive agent. Whilst cost-effectiveness is an important consideration, from an ethical standpoint the protection of oral health should not be viewed purely in economic terms. The oral health care professional should monitor and reapply sealants as needed to maximize effectiveness.
