Retention and Effectiveness of School-based Dental Sealant Programs in Lucknow – A Randomized Controlled Trial

Abstract

Background: Pit-and-fissure sealants, particularly the resin-based type, are widely used as the most efficient technique for preventing caries on the occlusal surfaces of permanent molars. School-based dental sealant (SBDS) program is a system where sealants are applied to the children in their schools with the primary aim to certify and safeguard the permanent molars that are sealed at the earliest after eruption. Aim: The aim of this study was to evaluate the retention and effectiveness of SBDS Programs in Lucknow, UP. Materials and Methods: A split-mouth randomized controlled trial was conducted among 6-year-old school-going children of Lucknow, UP. The study was carried out by a single trained and calibrated investigator who recorded the dentition status. The investigator interviewed the participants using a pro forma and examined the subjects included in the study. The sealant was applied to one tooth in the pair of fully erupted permanent first molars, and no treatment was done on the other side. Results: The proportion of total retention after 1½ years was significantly higher in mandibular as compared with maxillary molars (Z = 2.04; P = 0.04). The risk of having caries was 3.52 times more among children with no treatment as compared to children with treatment (odds ratio [OR] – 3.52 [1.01, 13.11]; P = 0.04; statistically significant). The association between survival rate of sealant and International Caries Detection and Assessment System codes (0 and 1–2) as well as that between retention of sealant and caries status was statistically significant (P < 0.01 and 0.00001, respectively). The risk of having caries was 1.28 times more among males as compared to females (OR – 1.28 [0.38, 4.24]; P = 0.06), 1.61 times for sugar exposure (OR – 1.61 [0.53, 6.19]; P = 0.53; nonsignificant). Conclusion: Sealant application proved to be an efficient method in preventing dental caries development; hence, SBDS programs, wherein the sealants were placed at school, were highly efficacious and acceptable in the vulnerable populace.