Sealants for preventing tooth decay in baby teeth

Tooth decay is common and can affect the overall well‐being of children. The back teeth are the teeth that become decayed most often. Their biting surfaces are not flat and have grooves that can retain bits of food and bacteria, leading to tooth decay forming on the teeth. In addition, the opening of these grooves is so small that a toothbrush bristle cannot enter them completely, making them difficult to clean. Sealing the grooves is one of the ways to prevent decay in back teeth. Sealants act as a protective barrier against food and bacteria, and may prevent harm to the teeth.

What was the research?

A systematic review to explore whether putting sealants over the biting surfaces of baby teeth in the back of the mouth prevents tooth decay from forming in them.

Who conducted the research?

The research was conducted by a team led by Priyadarshini Ramamurthy of SEGi University, Kotadamansara, Malaysia on behalf of Cochrane Oral Health. Avita Rath, Preena Sidhu, Bennete Fernandes, Sowmya Nettem, Patrick A. Fee, Carlos Zaror and Tanya Walsh were also on the team.

What evidence was included in the review?

The review includes studies available from a search of the literature up to 11 February 2021. We included 9 randomised controlled trials, including 1,120 children aged between 18 months and 8 years old. The studies used a variety of dental sealants to prevent tooth decay in baby teeth. 

What did the evidence say?

Three studies compared sealants with no sealants, and six studies compared different materials or processes to seal the tooth surface. As there were important differences in the design of the studies in terms of the sealant types, the age of the children at the start of the trial and the length of follow‐up, we were unable to reach a conclusion. Only one trial assessed and reported side effects, the nature of which was gag reflex while placing the sealant material.

How good was the evidence?

We found low‐quality evidence regarding the effectiveness of sealants in preventing tooth decay on biting surfaces of back baby teeth in children. This means that we are unable to draw conclusions about the effectiveness of sealants compared to no sealant or a different sealant in preventing the development of decay on baby teeth in children.

What are the implications for dentists and the general public?

The effectiveness of sealants on baby teeth has not been established. However, a previous review by Cochrane Oral Health found evidence that resin-based sealants applied to permanent (adult) teeth reduced caries when compared to no sealant (see our previous blog post for details).

What should researchers look at in the future?

We assessed most studies as being at high risk of bias overall because the dental professionals who were measuring the outcomes could see whether a sealant had been placed. There is evidence that sealants are effective in permanent teeth. However, the evidence is lacking for primary teeth. More randomised controlled trials conducted in baby teeth for assessing the effectiveness of sealants in preventing tooth decay are needed. Most of the trials included in this review were too short, with typical follow‐up of 12 months. More well‐conducted studies with long follow‐up times are needed.

Link

Ramamurthy P, Rath A, Sidhu P, Fernandes B, Nettem S, Fee PA, Zaror C, Walsh T. Sealants for preventing dental caries in primary teeth. Cochrane Database of Systematic Reviews 2022, Issue 2. Art. No.: CD012981. DOI: 10.1002/14651858.CD012981.pub2.

This post is an extended version of the review’s plain language summary, compiled by Anne Littlewood at the Cochrane Oral Health Editorial Base.