Originally posted 17 April 2009
The American Dental Association has a bit of a track record of supporting dental procedures – the use of mercury fillings, fluoride, sealants – that have been shown to be potentially hazardous and, at best, only minimally effective. What’s especially stunning is when studies highlighting this fact show up in JADA, the organization’s own publication – such as last year’s review showing that fluoride treatments don’t do much to reduce the risk of cavities in young kids but do increase their risk of developing fluorosis. (You can read our comment on this study here.)
Now, JADA has published a review of the scientific literature on sealant effectiveness and the development of caries (cavities). Specifically, its authors looked at the risk of caries in teeth that had been treated but since lost some or all of the sealant. Then they compared this to the risk in teeth that had never been so treated. Their conclusion:
Teeth with fully or partially lost sealant were not at a higher risk of developing caries than were teeth that had never been sealed. (Emphasis added)
This, of course, begs the question: If the risk of caries is the same under both conditions, why apply sealants at all?
So here’s the punchline: though they don’t appear to make much of a difference, sealants should be used anyway:
Inability to provide a retention-check examination to all children participating in school sealant programs because of loss to follow-up should not disqualify a child from receiving sealants.