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J Dent Res. 2017 Jul;96(7):754-761. doi: 10.1177/0022034517702094. Epub 2017 Apr 10.

Fissure Seal or Fluoride Varnish? A Randomized Trial of Relative Effectiveness.

Author information

1
1 Applied Clinical Research and Public Health, School of Dentistry, Cardiff University, Cardiff, UK.
2
2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK.
3
3 DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK.
4
4 Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK.
5
5 Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, UK.

Abstract

Fissure sealant (FS) and fluoride varnish (FV) are effective in preventing dental caries when compared with a no-treatment control. However, the relative clinical effectiveness of these interventions is uncertain. The objective of the study was to compare the clinical effectiveness of FS and FV in preventing dental caries in first permanent molars (FPMs) in 6- to 7-y-olds. The study design was a randomized clinical trial, with 2 parallel arms. The setting was a targeted-population program that used mobile dental clinics in schools located within areas of high social and economic deprivation in South Wales. A total of 1,016 children were randomized 1:1 to receive either FS or FV. Resin-based FS was applied to caries-free FPMs and maintained at 6-mo intervals. FV was applied at baseline and at 6-mo intervals for 3 y. The main outcome measures were the proportion of children developing caries into dentine (D4-6MFT) on any 1 of up to 4 treated FPMs after 36 mo. At 36 mo, 835 (82%) children remained: 417 in the FS arm and 418 in the FV arm. A smaller proportion of children who received FV ( n = 73, 17.5%) versus FS ( n = 82, 19.6%) developed caries into dentine on at least 1 FPM (odds ratio [OR] = 0.84; 95% CI, 0.59 to 1.21; P = 0.35), a nonstatistically significant difference between FS and FV treatments. The results were similar when the number of newly decayed teeth (OR = 0.86; 95% CI, 0.60 to 1.22) and tooth surfaces (OR = 0.85; 95% CI, 0.59 to 1.21) were examined. In a community oral health program, semiannual application of FV resulted in caries prevention that was not significantly different from that obtained by applying and maintaining FS after 36 mo (EudraCT: 2010-023476-23; ISRCTN: ISRCTN17029222).

KEYWORDS:

clinical effectiveness; clinical trial; dental caries; dental public health; molar; prevention

PMID:
28394709
DOI:
10.1177/0022034517702094
[Indexed for MEDLINE]

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