The combined use of pit and fissure sealants and fluoride mouthrinsing in second and third grade children: final clinical results after two years.

The combined benefits of pit and fissure sealants and weekly mouthrinsing with a 0.2% neutral NaF solution were assessed in children who initially had no caries or restorations in their permanent teeth. Ninety-five children participating in a school-based weekly fluoride mouthrinsing program since kindergarten had sealants applied to their first permanent molars when they were in the second and third grades. Only 3 lesions were found in the 84 children who were available for examination after 2 years; 96.4% remained caries free. One hundred thirty-one children who participated in the fluoride mouthrinsing program but who did not have sealants applied served as the control group. A large percentage of these children were eliminated from the study because sealants were applied to their teeth by private dentists. In the 51 children who were available after 2 years, 24 surfaces had decayed or were restored, and 78.4% of the children were caries free. The combination of pit and fissure sealants and weekly fluoride mouthrinsing resulted in the nearly complete elimination of new carious lesions. Because fluoride mouthrinsing has its greatest relative caries protective benefit on smooth tooth surfaces and since sealants protect only pit and fissure surfaces, several investigators have used these methods in combination on the same subjects. 1 Ripa et al. (1986) have reported the first year’s results of a pilot study in which sealants were applied to the first permanent molars of children who were already participating in a school-based fluoride mouthrinsing program. This report presents the final results of this study 2 years after sealant placement. The purpose of the study was to compare the caries increments of the sealant ! F-mouthrinse treated children to children who were only participating in i Bagramian et al. 1978; Bagramian 1982; Bell et al. 1984; Low 1982; Rantala 1979. the mouthrinse program. The status of the sealants also was assessed. Methods and Materials Ninety-five second and third grade children (ages 7-8 years) had their 4 first permanent molars sealed with an autopolymerized sealant, a The sealant was applied to all 4 occlusal surfaces. In addition, the buccal pits of the mandibular molars and lingual grooves of the maxillary molars were treated--provided they were sufficiently erupted to maintain dryness. Based upon a visual-tactile examination using the criteria of Radike (1972), the children, who were in the mixed dentition, had no caries or fillings in their permanent teeth at the baseline examination. All of the children were enrolled in a school-based fluoride mouthrinsing program since kindergarten in which they rinsed once a week under supervision with a 0.2% neutral NaF solution (Ripa et al. 1983). The control group of subjects initially consisted of 131 second and third graders who also participated in the fluoride mouthrinsing program since kindergarten but who did not receive sealants. All of their permanent teeth were caries free at the time of their entrance into this study. The treated and control group of children were re-examined after 1 year at which time 87 and 81 children, respectively, were available. At this visit, missing sealant was replaced if the surface was caries free. A final visual-tactile caries examination was conducted after 2 years by the same examiner. A detailed description of the study methods is available in the article which presents the first year’s results (Ripa et al. 1986). Delton Tinted Sealant--Johnson & Johnson Dental Products Co; East Windsor, NJ. 118 SEALANTS AND FLUORIDE MOUTHRINSING: Ripa et al. TABLE 1. Two-Year Caries Increment of Initially Caries-Free Second and Third Grade Children Total NumDF Surface Distribution Number of Number DFS ber of DF Group Subjects Per Child Surfaces Occ B L Prox F-mouthrinse/sealant 84 0.03 3 2 0 1 0 F-mouthrinse 51 0.47 24 15 7 2