Monday, August 21, 2017

Caries risk in formerly sealed teeth

Department of Pediatric Dentistry
Lutheran Medical Center
           
Resident’s Name: Olga Raptis                                                                                         Date:  08/21/17

Article Title: Caries risk in formerly sealed teeth.
Author(s): Griffin, S. O., et al.
Journal: J Am Dent Assoc (2009) 140(4): 415-424. 
Date: April 2009
Major Topic: Dental Sealants
Type of Article: Systemic review of articles
Main Purpose: Examine risk of caries development in teeth with partially or fully lost sealants (formerly sealed FS teeth) compared to risk in teeth never having sealants (never-sealed NS teeth)
Key Points: (2 lines Max): Main conclusion or the most interesting
Caries incidence among never-sealed teeth at the first-year follow-up examination ranged from 24 to 47 percent.

       The findings indicate that individual teeth with partial or complete loss of sealant are not at a higher risk of developing caries than they would be if they never had received sealants. 


     Calculated RR = % FS developing caries/ % NS developing caries 

       The caries rate in formerly sealed teeth is less than or equal to the rate in never-sealed teeth. 
      
     The weighted mean relative risk (RR)  was less than 1 for all four years after sealant placement, and the median relative risk also was less than 1 for all years after placement. 
    
         These findings suggest that heightened concern about partially lost sealants trapping food and thus increasing the risk of caries development may be unfounded.

     Individual teeth w/ partial or complete loss of sealant are not at higher risk of developing caries than if they were never sealed

     Current guidelines recommend sealant placement only when there is a risk of caries development. Since  sealant effectiveness is linked directly to retention, the maximum protection against caries can be achieved when a sealant is fully retained.
      
     One study included in the analysis found that sealant effectiveness increased with the extent of retention.
Remarks:
1-  The FS teeth with fully or partially lost sealant were not at a higher risk of developing caries than were NS teeth.
2 - The inability to provide a retention examination to all children participating in a school-based program because of potential loss to follow-up should not exclude any child from having access
Assessment of Article:  Level of Evidence/Comments: Systemic Review 

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