A 13-year follow-up of a comprehensive program of fissure sealing and resealing in Varkaus,Finland

The objective of the study was to examine the coverage of the sealing program on first permanent molars (FPMs) and second permanent molars (SPMs) and first and second premolars (FSPMs), as well as to monitor the fate of the sealed teeth over time. All patients born in 1977 who had had regular check-ups in the Varkaus Health Center, Finland (n = 166) were included in the 1996 study. Data on the annual state of each tooth had been collected retrospectively since 1983. The coverage for the sealant program was 95%, 92%, and 6% of the FPMs, SPMs, and FSPMs, respectively. Out of the FPMs sealed at age 6 years, 28% were subjected to resealing, 13% developed occlusal, and 15% proximal caries during a 13-year follow-up period. From the SPMs sealed at age 11 years, 24% were subjected to resealing, 4% developed occlusal caries, and less than 2% proximal caries during the 9-year follow-up. None of the sealed FSPMs and only 1% of the non-sealed ones developed occlusal caries during the 9-year period. The mean DMF in the study population (n = 160) at age 12 years was 0.8 (n = 124), compared to a nation-wide mean value of 1.2. A large percentage of the FPMs and SPMs were sealed and then resealed during the study period. Although the study design lacked a control group for comparison, the lower caries rates of this study compared to the results of other studies with only a single application of sealants suggest a major role for resealing.