Clinical and economic analysis of dental caries prevention using fluorine-containing sealants

Aim. To conduct a clinical and economic analysis of the effectiveness of the program fissure sealing of first permanent molars with fluorine-containing sealants among schoolchildren of 78 years old in six cities of the Republic of Tatarstan. Methods. Between 2007 and 2011, dentists of six cities of the Republic of Tatarstan performed fissure sealing of permanent first molars using a fluorine-containing sealant in 24,394 schoolchildren aged 78 years according to the manufacturer's instruction. A clinical assessment of fluorine-containing sealant retention during tooth eruption was carried out annually, the results were submitted to the organizational and methodological office of the Republican Dental Clinic. The analysis of the complex of signs that have a normal distribution and characterize four degrees of sealant retention on the occlusal surfaces of teeth in children from several cities was carried out by using one-way ANOVA (analysis of variance) with the calculation of a p-value and F-test (according to Ronald Fischer). Statistical data processing was performed using the Microsoft Office Excel 2017 software. The economic analysis was performed by using mathematical modelling. Results. The use of sealants at the age of 78 years ensured the complete safety of the sealant in 80% of children; the development of dental caries in 1.7%; complete and partial loss 14.3%; disturbance of fit without the development of caries in 4.1% of cases [р=0.0095 (0.01); f-test 3.09839]. Clinical and economic analysis using a mathematical hypothesis in sealing with a fluorine-containing composite sealant determined the preservation of the conditionally spent funds for the treatment of 80% of healthy teeth for 4 years of the project in the amount of 6,001,177 rubles. Notional saved costs for the treatment of one tooth with a sealant amounted to 23.7 rubles. Conclusion. Implementation of the program fissure sealing of first permanent molars with fluorine-containing sealants among schoolchildren of 78 years old allows a total of 98.3% of healthy teeth to be preserved and notionally saved costs of sealing fissures to be reduced.

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Dental Plaque and Caries on Occlusal Surfaces of First Permanent Molars in Relation to Stage of Eruption

Journal of Dental Research ◽

10.1177/00220345890680050401 ◽

1989 ◽

Vol 68 (5) ◽

pp. 773-779 ◽

Cited By ~ 134

Author(s):

J.C. Carvalho ◽

K.R. Ekstrand ◽

A. Thylstrup

Keyword(s):

Dental Caries ◽

Oral Hygiene ◽

Dental Plaque ◽

Detector System ◽

Clear Pattern ◽

Occlusal Surfaces ◽

Permanent Molars ◽

Full Occlusion ◽

Favorable Conditions ◽

First Permanent Molars

The occlusal surfaces of partly and fully erupted first right permanent molars were examined with respect to the occurrence and distribution of plaque and dental caries in a group of 57 six- to eight-year-old children. The children were classified into four groups ranging from one tooth partially erupted to full occlusion. Occlusal plaque was recorded at two levels of examination: (1) visible plaque and (2) detailed mapping by means of a plaque detector system. Dental caries was recorded after professional cleaning. The recording of plaque was repeated after 48 hr without oral hygiene. The findings showed a significant reduction in the easily detectable plaque in fully erupted teeth, compared with the three groups representing partly erupted teeth. The detailed mapping of plaque showed a clear pattern of preferential locations related to the macromorphology of the occlusal surfaces, and revealed reduction in the frequency of thick plaque accumulation in the fully erupted teeth. The proportion of active lesions was reduced in fully erupted teeth, and arrested lesions were mainly observed in the same group. This indicated that erupting teeth are more likely to develop dental caries, due to favorable conditions for plaque accumulation. Functional usage of teeth in addition to improved access for toothbrushing promoted arrestment of lesions initiated during eruption.

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PERBEDAAN TOPICAL FLUORIDE APPLICATION DAN FISSURE SEALANT DALAM MENCEGAH KARIES PADAGIGI MOLAR SATU

Jurnal Vokasi Kesehatan ◽

10.30602/jvk.v3i2.112 ◽

2017 ◽

Vol 3 (2) ◽

pp. 98

Author(s):

Pawarti Pawarti ◽

Fathiah Fathiah

Keyword(s):

Time Series ◽

Dental Caries ◽

Topical Application ◽

P Value ◽

Fissure Sealants ◽

Fissure Sealant ◽

Permanent Molars ◽

Topical Fluoride ◽

Pits And Fissures ◽

First Permanent Molars

Abstract: Topical Fluoride Application And Fissure Sealant To Prevent Dental Caries Permanent First Molars. Anatomy pits and fissures of teeth are caries initiation vulnerable areas of the permanent molars that grow at the age of 6 years where children can not perform oral hygiene. Caries prevention can be done by closing the pits and fissures or application of fluoride (topical fluoride application) on the surface of the teeth. The purpose of this study was to analyze the difference fissure sealants and topical application of fluoride to prevent dental caries of first permanent molars. This study was a quasi-experimental study with time series, a sample was taken by purposive 117-second grade students of SDN District of North Pontianak. Data were analyzed using t-test. The result showed that fissure sealant more effective in caries prevention of first permanent molar than topical fluoride application where there were none caries teeth after and month fissure sealant, 25% sealant partially off and 11% fully off. Teeth that have done fluoride after 6 months of 3.9% of dental caries, the eighth month of 5.4% of dental caries. There was a significant difference between the effectiveness of fissure sealants with topical application of fluoride to prevent dental caries in first permanent molars p-value < 0.05, after 6-month p-value: 0.004 and after 8-month p-value: 0.001.Abstrak: Topical Fluoride Application Dan Fissure Sealant Untuk Mencegah Karies Pada Gigi Molar Satu Permanen. Anatomi pit dan fisura gigi merupakan daerah rentan inisiasi karies gigi molar satu permanen yang tumbuh pada usia 6 tahun anak belum bisa melakukan kebersihan mulutnya. Pencegahan karies dapat dilakukan dengan cara menutup pit dan fissure atau pengolesan fluor (topical fluoride application) pada permukaan gigi. Tujuan penelitian ini untuk menganalisis perbedaan efektivitas fissure sealant dan topical fluoride application untuk mencegah karies gigi molar satu permanen anak usia 6 sampai 7 tahun .Penelitian ini merupakan experimental semu dengan studi time series , evaluasi perlakuan dilakukan setelah 3 bulan, 3 bulan dan 8 bulan, Sampel diambil secara purposive yaitu 117 siswa kelas 2 SDN Kecamatan Pontianak Utara. Analisis data menggunakan uji t tes. Hasil penelitian menunjukan fissure sealant lebih efektive mencegah karies pada molar satu permanen dibanding topical fluoride application pada tindakan fissure sealant setelah 8 bulan tidak ada gigi karies, 25 % sealant lepas sebagian dan 11% lepas seluruhnya. Gigi yang dilakukan pengolesan fluor setelah 6 bulan 3,9% gigi karies, bulan ke delapan 5,4% gigi karies, Ada perbedaan efektivitas yang signifikan antara fissure sealant dengan topical flouride application dalam mencegah karies gigi molar satu permanen dengan nilai p <0,05, yaitu pada bulan ke 6 (enam) nilai p : 0,004 dan pada bulan ke 8 (delapan) nilai p : 0,001.

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Fluoride Varnishes for Preventing Occlusal Dental Caries: A Review

Dentistry Journal ◽

10.3390/dj9060064 ◽

2021 ◽

Vol 9 (6) ◽

pp. 64

Author(s):

Alaa Baik ◽

Najlaa Alamoudi ◽

Azza El-Housseiny ◽

Amani Altuwirqi

Keyword(s):

High Risk ◽

Dental Caries ◽

Caries Prevention ◽

Fluoride Varnish ◽

Fissure Sealants ◽

Occlusal Caries ◽

Vast Number ◽

Occlusal Surfaces ◽

Permanent Molars ◽

First Permanent Molars

Dental caries are most likely to occur on occlusal surfaces from the early eruptive stages of the tooth. In children, about 80% to 90% of dental caries are occlusal caries. Different preventive modalities are used to prevent occlusal caries. One of the methods used for occlusal caries prevention is fluoride varnish. A vast number of clinical trials have evaluated several types of sealant material and fluoride varnish to assess their ability to prevent occlusal caries in both primary and permanent dentition. The purpose of the current study was to provide an updated overview of the development, composition, mechanism of action, application, and safety of fluoride varnish, as well as its effect on occlusal caries prevention. This review of recently published studies on fluoride varnish and its effect on occlusal caries prevention shows that in children at moderate to high risk of caries, fluoride varnishes prevent occlusal caries. Both resin-based fissure sealants and fluoride varnish are effective for occlusal caries prevention for first-permanent molars. However, it was not possible to identify which one has the best effect. It is recommend that fluoride varnish is applied for children at high risk of caries two to four times per year.

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Dental caries and their treatment in first permanent molars

ORL ro ◽

10.26416/orl.37.4.2017.1303 ◽

2017 ◽

Vol 4 (37) ◽

pp. 46

Author(s):

Irina-Maria Gheorghiu ◽

Loredana Mitran ◽

Alexandru A Iliescu ◽

Sânziana Scărlătescu ◽

Paula Perlea ◽

...

Keyword(s):

Dental Caries ◽

Permanent Molars ◽

First Permanent Molars

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Fissure sealing of first permanent molars. An improved technique applied by a dental auxiliary

BDJ ◽

10.1038/sj.bdj.4804019 ◽

1978 ◽

Vol 144 (1) ◽

pp. 7-10 ◽

Cited By ~ 12

Author(s):

K W Stephen ◽

M Kirkwood ◽

K C Young ◽

F C Gillespie ◽

E E MacFadyen ◽

...

Keyword(s):

Permanent Molars ◽

Improved Technique ◽

Fissure Sealing ◽

First Permanent Molars

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Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

Journal of Dental Research ◽

10.1177/0022034514551753 ◽

2014 ◽

Vol 93 (11) ◽

pp. 1070-1075 ◽

Cited By ~ 42

Author(s):

M. Fontana ◽

J.A. Platt ◽

G.J. Eckert ◽

C. González-Cabezas ◽

K. Yoder ◽

...

Keyword(s):

Assessment System ◽

Retention Rates ◽

Caries Detection ◽

Major Barrier ◽

Occlusal Surfaces ◽

Before And After ◽

Permanent Molars ◽

Caries Lesions ◽

Sealant Retention ◽

Lesion Severity

Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 ( i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair.

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Clinical study: Comparison of Er,Cr:YSGG laser treatment versus conventional treatment of fissure sealing in first permanent molars

Medicina Oral Patología Oral y Cirugia Bucal ◽

10.4317/medoral.17643591 ◽

2012 ◽

pp. S92-.

Author(s):

G Schindler-Hultzsch ◽

N. Gutknecht

Keyword(s):

Clinical Study ◽

Laser Treatment ◽

Conventional Treatment ◽

Permanent Molars ◽

Fissure Sealing ◽

First Permanent Molars

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Sealant Effectiveness for Children Receiving a Combination of Preventive Methods in a Fluoridated Community: Two-Year Results

Journal of Dental Research ◽

10.1177/00220345770560121801 ◽

1977 ◽

Vol 56 (12) ◽

pp. 1511-1519 ◽

Cited By ~ 10

Author(s):

Robert A. Bagramian ◽

Richard C. Graves ◽

Sujan Srivastava

Keyword(s):

First Graders ◽

Dental Health ◽

Sixth Graders ◽

Occlusal Caries ◽

Permanent Molar ◽

Occlusal Surfaces ◽

Molar Teeth ◽

Permanent Molars ◽

Preventive Methods ◽

Sealant Retention

A series of preventive methods in combination have been used to reduce dental caries in children including dental health education, prophylaxes, pit and fissure sealants, topical application of fluoride and restorative care. Prophylaxes, sealant, and fluoride procedures are repeated every six months. Two-year results show reductions of occlusal caries increments of 74.3% for first graders and 77.1% for sixth graders. Sealant loss, as defined in this study, varied from 33% to 90% with the highest loss occurring in the newly erupted permanent molars during the first six months of the project. These high sealant loss rates are thought to be related to the age of the population which was designed to include children at the ages of peak eruption of permanent molar teeth (ages six and twelve). These teeth were often only minimally erupted and maintaining the dry field required for sealant retention was extremely difficult. However, in spite of these high rates of sealant loss, caries reduction on occlusal surfaces was highly significant in comparison to that of children who did not receive sealants.

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Dental caries is concentrated in the first permanent molars

BDJ ◽

10.1038/sj.bdj.4809639 ◽

1998 ◽

Vol 184 (8) ◽

pp. 387-387

Author(s):

D W Sarll

Keyword(s):

Dental Caries ◽

Permanent Molars ◽

First Permanent Molars

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Estimation of Caries Treatment Needs in First Permanent Molars of Lithuanian 5–6-Year-Old Children, Based on Caries Lesion Activity Assessment

Medicina ◽

10.3390/medicina56030105 ◽

2020 ◽

Vol 56 (3) ◽

pp. 105

Author(s):

Vita Mačiulskienė ◽

Jaunė Razmienė ◽

Vilija Andruškevičienė ◽

Eglė Bendoraitienė

Keyword(s):

Dental Caries ◽

Dental Plaque ◽

Cluster Sampling ◽

Treatment Needs ◽

Caries Lesion ◽

Activity Assessment ◽

Caries Treatment ◽

Permanent Molars ◽

Caries Lesions ◽

First Permanent Molars

Background and Objectives: Early detection of dental caries lesions at active stages of development can facilitate their monitoring and reduce needs for restorative dental care. This study aimed to describe the prevalence and caries treatment needs in first permanent molars of pre-school children, based on a caries lesion activity assessment, and in relation to participants’ ages, dental plaque levels and toothbrushing habits. Materials and Methods: Large cross-sectional dental caries survey using multistage cluster sampling was conducted among Lithuanian 4–6-year-old children attending kindergartens. For the present study purpose, all individuals presenting erupted permanent molars were selected. Thus, only 5–6-year-olds (n = 453) took part in this study. They were examined for caries by one calibrated examiner using Nyvad clinical diagnostic criteria that differentiate between active and inactive caries lesions. Dental plaque was assessed by the Silness-Löe index, and parents’ reports about toothbrushing frequency were collected. Results: Overall, 41% of permanent molars were affected by caries; 6-year-olds had more caries lesions than 5-year-olds (p < 0.05). Mean number of decayed and filled surfaces (DF-S) of all participants was 1.79 (SD 2.93), half of lesions were noncavitated, more than one-third were cavitated and fillings comprised less than one surface per child. Majority of lesions were active; prevalence of inactive lesions (all noncavitated) was 1% and 6% in 5- and 6-year-olds, respectively. Prevalence of active lesions increased with age; it correlated with plaque levels and with toothbrushing frequency (<0.001). Likelihood to detect active lesions was up to nine times higher in teeth with abundant plaque (odds ratio (OR) 8.73; confidence interval (CI) 5.35–14.25), and up to seven times higher in individuals brushing teeth irregularly (OR 6.88; CI 2.21–21.41). Conclusions: The obtained data indicate high treatment needs in the erupted permanent molars of the Lithuanian pre-school population and imply that caries management should primarily focus on improved biofilm removal, accompanied with regular use of fluoridated toothpaste.

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