The 30-month Effect of Fluoridated Sealants on Adjacent Tooth Surfaces

Objectives: A double-blind randomized clinical trial (30-months) was designed and performed in 6-7 years schoolchildren to evaluate whether the caries increment on the distal surface of the second primary molars adjacent to permanent first molars sealed with fluoride releasing compounds would be lower with respect to those adjacent to permanent first molars sealed with a non-fluoridated sealant. Methods: 2776 subjects were enrolled and randomly divided into three groups receiving sealants on sound first molars, as follows: 1) a high-viscosity Glass-Ionomer-Cement (GIC); 2) a Resin-Based sealant with Fluoride (Fluoride-RB); and 3) a Resin-Based sealant without fluoride (RB). Caries (D1-D3 level) was recorded on the distal surface of the second primary molar, considered the unit of analysis including only sound surfaces at the baseline. Results: At baseline, no differences in caries prevalence were recorded in the three groups regarding the evaluated surfaces. At follow-up, the prevalence of an affected unit of analysis was statistically lower (p=0.03) in the GIC and Fluoride-RB groups (p=0.04). In the GIC group less new caries were observed in the unit of analysis respect to the other two groups. Incidence Rate Ratios (IRR) was 0.70 (95%CI for IRR 0.50-0.68 p<0.01) for GIC vs RB; IRR was 0.79 (95%CI for IRR =0.53-1.04 p=005) for Fluoride-RB vs RB. Caries incidence was significantly associated to low SES; IRR=1.18 (95%CI for IRR=1.10-1.42 p=0.02). Conclusion: Dental sealant with high-viscosity GIC and Fluoride-RB have demonstrated to provide protection against dental caries even in the tooth nearest to the sealed tooth. (Trial Registration Number NCT01588210 05/17/2012)