Fissure sealants on first molars – consequences of a one-year delay

Most dental caries occur on the occlusal surfaces of 1st molar teeth. While fissure sealants have been found to be effective, the timing of their placement is important. They should be preferably done soon after eruption. Objective: The aim of this study was to compare the dental caries status of Grade 2 (7-8 years of age) children who kept and missed their Grade 1 (6-7 years of age) dental public health clinic appointment. Methods: Data were obtained from the dental clinic records of schoolchildren attending the public dental clinic. Of the 270 children in the study, 185 (68%) attended the dental clinic in Grade 1 while 85 (32%) missed their Grade 1 appointment. Results: Children who missed their Grade 1 visit to the dental clinic had significantly more decayed and missing permanent tooth surfaces (mean DMFS=1.06) compared to children who attended the clinic in Grade 1 (mean DMFS=0.32). Overall, in Grade 2 about a quarter of non-sealed first molars were carious compared to 10% that were sealed in the first year of schooling. The lower right molar was 6 times more likely to experience decay on the occlusal surface in children who missed the appointment compared to those who kept the appointment. Conclusion: A one year delay in fissure sealing the occlusal surfaces of 1st molars significantly increased the likelihood dental caries on these teeth.