Guidelines on the use of Pit and Fissures Sealants

DEFINITION

"A fissure sealant is a material that is placed in the pits and fissures of teeth in order to prevent or arrest the development of dental caries".

 INTRODUCTION

 Tooth surfaces with pits and fissures are particularly vulnerable to caries development (Manton and Messer, 1995).  Ripa (1973) observed that although the occlusal surfaces represented only 12.5% of the total surfaces of the permanent dentition, they accounted for almost 50% of the caries in school children.  This can be explained by the morphological complexity of these surfaces, which favours plaque accumulation to the extent that the enamel does not receive the same level of caries protection from fluoride as does smooth surface enamel (Ripa, 1973;  Bohannan, 1983;  Ripa, 1990).  The plaque accumulation and caries susceptibility are greatest during the eruption of the molars (Carvalho et al, 1989), and caries susceptible individuals are therefore vulnerable to early initiation and fast progression of caries in these sites.  Brown et al (1996) and Kaste et  al (1996) showed that in fluoridated communities, over 90% of dental caries is exclusively pit and fissure caries.