Dental sealant knowledge, opinion, values and practice of Spanish dentists

IntroductionThe aims of this study were to assess the prevalence of dental caries and the DMFT index, as well as the distribution pattern of pit and fissure sealants on permanent teeth in a Portuguese sample of adolescents, and to assess whether the existing usage of sealants and socio-demographic factors are correlated to caries prevalence on the examined sample.Materials and MethodsA cross-sectional study was designed with a sample of 447 adolescents aged 12 to 18 years old, attending a public school in Sátão, Portugal. A self-administered questionnaire with questions about oral health behaviours and socio-economic status was answered by adolescents in the classroom. Clinical examination of oral health status and assessment of fissure sealants were accomplished by only one trained member of the research team.ResultsWe obtained a DMFT index of 3.32 (2.92), which indicates a moderate level of prevalence of dental caries. When considering a DMFT = 0, we found significant statistical differences between the parents´ level of education (≤ 4th grade = 26.3 vs 5th–12th grade = 18.8 vs <12th grade = 43.3, p = 0.001), gender (male = 27.3 vs female = 19.6, p = 0.04), age (≤15 years = 27.1 vs <15 years = 18.5, p = 0.02), presence of fissure sealants (yes = 30.6 vs no = 13.5, p = 0.001) and experience of dental pain (no = 25.4 vs yes = 16.8, p = 0.02). When analyzing the prevalence of fissure sealants, we verified that 58.8% of adolescents had at least one fissure sealant applied. Significant statistical differences were found when analyzing the presence of fissure sealants related with parents´educational level (<9th grade, OR = 1.56 CI95% = 1.05–2.54), gender (female, OR = 1.86 CI95% = 1.19–2.98), experience of dental pain (yes, OR = 0.62 CI95% = 0.39–0.97) and presence of dental caries (yes, OR = 0.35 CI95% = 0.19–0.65).ConclusionsThe moderate level of caries prevalence reveals the need of improvement of primary prevention interventions among Portuguese adolescents. The establishment of a more targeted preventive program with better and more effective oral health education is essential, having into account socio-demographic aspects.

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“…Therefore, economic variables appear to be one of the reasons for the absence of fissure sealants among adolescents. [16,30,31]…”

Section: Discussionmentioning

confidence: 99%

“…(2013) concludes that dentists may be underusing fissure sealants, even when knowing that a fissure sealant is effective and has positive effects on the prevention of oral diseases. [16]…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Dental Caries and Fissure Sealants in a Portuguese Sample of Adolescents

et al. 2015

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“…according to ICDAS II criteria (0-4). The 120 randomly numbered samples included, 40 sound teeth and 20 teeth in each of the ICDAS II lesion categories (1)(2)(3)(4). Samples were photographed and then radiographed using a wireless Schick digital sensor (3 mA, 70 kVp, 0.050 seconds).…”

Section: Protocolmentioning

confidence: 99%

Assessment of early occlusal caries pre‐ and post‐ sealant application—An imaging approach

et al. 2014

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Background and Objective Clinicians have difficulty assessing and monitoring early occlusal caries. Traditional clinical exam and radiographs are unable to detect the subtle alterations in enamel indicative of de- or re-mineralization, particularly under dental sealants. Although clinicians have used laser fluorescence (LF) to address this gap, this modality has demonstrated weak correlation with histology. The International Caries Detection and Assessment System (ICDAS-II) has demonstrated high sensitivity and specificity for caries detection, but since it is based on visual assessment, it is of no use in areas beneath the most commonly used dental sealants which are opaque. Optical Coherence Tomography (OCT) is an emergent assessment tool which has demonstrated great promise in detecting and quantifying caries, including areas beneath commonly used dental sealants and composites. However, OCT has not yet been widely integrated into clinical dental practice, perhaps because OCT imaging does not provide an easily accessible diagnostic outcome for clinicians. The objective of this ex vivo study was to use OCT-images of sound and carious occlusal surfaces in combination with a simple algorithm to compare the caries detection ability of OCT with tools clinicians may be more familiar with (LF and radiography), and with an established valid and reliable clinical assessment tool (ICDAS-II). Study Design/Materials and Methods One hundred and twenty extracted teeth with sound or naturally carious occlusal surfaces were imaged with OCT, LF, radiography, and examined clinically with the International Caries Detection and Assessment System. Teeth were randomized to one of two dental sealants recommended for use with LF. A novel simple algorithm was used to interpret OCT-based images. The accuracy of caries severity assessments of the OCT-based diagnosis, LF, ICDAS-II, and digital radiography were compared to the 4-point histological analysis gold standard. Results OCT and ICDAS-II caries severity assessments demonstrated high sensitivity (94.0%; 92.3%) and specificity (85.0%; 83.3%), LF demonstrated low sensitivity (65.2%) but high specificity (97.6%), and digital radiography demonstrated low sensitivity (67.1%) with moderate specificity (79.5%) on unsealed occlusal surfaces. OCT-based caries severity assessments of sealed teeth demonstrated high specificity (97.6%), sensitivity (89.9%), excellent positive predictive value (98.6%) and negative predictive value (83.3%). Despite our use of LF recommended dental sealants, in the presence of sealants, LF assessment of caries severity demonstrated high sensitivity (95.1%), but extremely low specificity (10.3%), positive predictive value (68.8%) and negative predictive value (50.0%). Conclusion This study found that OCT-based imaging combined with a simple diagnostic algorithm accurately assessed the severity of natural early caries on occlusal surfaces in extracted teeth both in the absence and presence of dental sealant. The findings of this study support the clinical u...

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“…: Spanish data found 48% of the respondents to avoid sealants because they fear to seal carious enamel. 55,56 Only 22% agreed that "sealants, besides being a preventive method, can also have a restorative effect and can be used on incipient carioues lesions". This result clearly showed that, despite two decades of accumulated evidence, the concept of therapeutic sealants have not been adopted in clinical routine.…”

Section: Commented [Sf3]mentioning

confidence: 99%

Managing caries: the need to close the gap between the evidence base and current practice

et al. 2015

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Dental sealant knowledge, opinion, values and practice of Spanish dentists

Cited by 21 publications

References 27 publications

Prevalence of Dental Caries and Fissure Sealants in a Portuguese Sample of Adolescents

Prevalence of Dental Caries and Fissure Sealants in a Portuguese Sample of Adolescents

Assessment of early occlusal caries pre‐ and post‐ sealant application—An imaging approach

Managing caries: the need to close the gap between the evidence base and current practice

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