Sealant Survival in a High Caries Population

Introduction: The literature reports that 10% of the sealants placed are lost each year. However most of this research was done in children with low caries rates. As sealants are being recommended for all children, their survival in children with high caries rates needs to be evaluated. Aim: To evaluate sealant survival in a high caries population (caries prevalence 91%) and compare them to low caries populations. Methods: Sealant retention in 2538 previously placed sealants in permanent first molars of children aged 6 to 8 years in 20 primary schools were evaluated. Following cleaning with pumice and rubber cup, and 20 seconds etching, sealants were placed in pit and fissure surfaces using either rubber dam or cotton roll isolation. The children were examined annually each April in 2003, 2004, 2005 and 2007. Sealant retention was evaluated each year, and was scored as complete retention, partial or complete loss of sealant. Restored and resealed teeth were also scored. Caries was scored in those teeth in which the sealant was partially or completely lost. Sealants were then categorized as satisfactory or unsatisfactory. Results: Overall, 79% of the sealants were completely retained in year 1; 72% in year 2; 61% in year 3; and 52% in year 5. In year 1, 95% were carious; 92% in year 2; 89% in year 3; and 84% in year 5. In survival analyses, after controlling for age at sealant application, number of teeth sealed, arch, and isolation, surface sealed was the only factor that predicted sealant survival. Sealants on occlusal surfaces were more likely to be completely retained than those on buccal or palatal surfaces. Conclusion: Our results indicate that sealant survival in a high caries population is no different than that expected in a low caries population.