Effects of glass ionomer cement, resin-based pit and fissure sealant and HF applications on occlusal caries in a developing country field trial

Abstract The aim of this community-oriented study was to evaluate different methods to prevent fissure caries. The following products and measures were tested: 1) glass ionomer cement (GIC) applied by dentist; 2) same material applied by short term (3 days) trained personnel (teachers); 3) application of a 0.5% HF solution three times; 4) an established autopolymerized resin based sealant (Delton). The study was performed in Bangkok, Thailand, a city in a developing country experiencing increasing caries prevalence. Children with at least three sound permanent molars from two age groups, 7–8 and 12–13-yr-olds respectively were chosen from very low to medium socioeconomic level families. 1264 children were systematically assigned to experiment or control groups based on school and DMFT. For the younger age group, the 2 yr mean DFS occlusal increment in the Control group was 0.66 surfaces. Significantly lower increments were observed in the GIC experimental group: O.I7 surfaces applied by the teachers and 0.32 applied by dentist, corresponding to 74% and 52% reductions, respectively. The mean increment in the HF group was 0.44 surfaces, a 33% reduction in relation to the Control group. For the 12–13-yr-olds, the mean occlusal surface DF increment was 0.70 surfaces in the Control group. Almost no occlusal increment was found in the Delton group, 0.05 DFS, a 93% reduction. In the GIC Dentist group, the DFS increment was 0.48 and in the Teacher group 0.56, corresponding to 31% and 20% reduction, respectively. A slight and nonsignificant increase of caries in relation to the Control group was observed in the HF group. Retention of Delton sealant was high, 92% after 6 months, retention of the GIC sealants was low. At the 6-months checkup, only 2–8% of these sealants were still present and also after reapplication, a majority was lost.