Fissure sealing - overtreatment or preventive need?

The aim of this longitudinal study was to assess detailed the status of pits and fissures in permanent molars to get information regarding their need of preventive care. 369 Westphalian children born in 1989 were examined as 8-yr-olds (1997) and as 10-yr-olds (1999). The surface-related caries status according the WHO criteria (1997) was completed by scoring non-cavitated carious lesions. Additionally, sealants in fissures and pits were recorded. A caries free mixed dentition was found in 36 % of the 8-yr-olds and in 39 % of the 10-yr-olds, resp. The caries prevalence was 2.4 dft/ 5.2 dfs/ 0.4 DMFT/ 0.5 DMFS at the age of eight and 1.5 dft/ 2.9 dfs/ 0.6 DMFT/ 0.9 DMFS at the age of ten. 0.3 DS were registered on the occlusal surface of first molars in 8-yr-olds and 0.4 DS in 10-yr-olds. 1.0 fissure sealants were scored in 8-yr-olds and 1.4 10-yr-olds. Sealed pits were rarely scored: 0.1 in 8-yr-olds and 0.2 in 10-yr-olds. The number of non-cavitated occlusal fissures raised from 0.8 in 8-yr-olds to 1.4 in 10-yr-olds. 0.7 initial carious pits were registered in 8-yr-olds and 1.0 lesions were found in 10-yr-olds, resp. We conclude that sealant application financed by insurance companies since 1993 for 6- to 17-yr-olds should be used more frequently by German general dental practitioners. On account of the increasing numbers of non-cavitated lesions sealants are highly effective to prevention caries in fissures and pits. Parole chiave: epidemiology, caries prevalence, fissure sealants