Thorough reviews of pit and fissure sealant are available in the literature. It is the intent of this paper to focus on the clinical aspects of pit and fissure sealant application and the most recent publications that support an evidence-based clinical application technique. Pit and fissure sealants were introduced in 1971 based on the pioneering studies of Buonocore. Additional work initiated by Handelman in 1972 looked specifically at what happens to the bacteria trapped underneath a sealant. Concerns that such entrapment could lead to propagation, or continued development, of caries under a well-sealed area, were mitigated by this and many other succeeding studies. It remains clear that the application of pit and fissure sealant to newly-erupted posterior (and occasionally, anterior) teeth is the best method we have in dentistry to prevent pit and fissure caries, and ⁄ or to prevent the continued development of incipient caries into frank caries when the incipient lesion is sealed over with resin.