Pit and Fissure Sealants in Caries Prevention: Materials, Techniques, and Evidence-Based Outcomes
DOI:
https://doi.org/10.48165/ajm.2026.9.01.21Keywords:
pit and fissure sealants, dental caries prevention, resin-based sealants, glass ionomer cement, caries risk assessment, evidence based dentistry, preventive dentistryAbstract
Dental caries is among the most common chronic diseases in the world that is disproportionately present in the occlusal surfaces of the posterior teeth with complex morphology of pits and fissures where there is the presence of biofilm and conducive demineralization by acid. Pit and fissure sealants are one of the prevention measures that serve as a strategy due to their ability to cause a barrier between the exposed tooth surface and the oral environment, and hence the prevention of bacterial colonization and consequent carious lesions. This narrative review focuses on the current evidence on the topic of pit and fissure sealants, including the history of sealant materials, the mechanisms of their application, their retention, their caries-preventive effectiveness, and their cost-effectiveness. The review combines the results of clinical trials, systematic reviews, meta-analyses that were carried out during a number of decades to present an all-encompassing evaluation of the purpose of sealants in modern preventive dentistry. Some of the key themes covered are comparative efficacy of resin based and glass ionomer sealants, effects of isolation and surface preparation methods on the retention of sealants, the use of sealants over incipient carious lesions and new bioactive materials. The literature is consistently in favor of the efficacy of pit and fissure sealants in preventing the occlusal caries by 60 to 90 percent when properly retained, and best results are noticed in the high risk groups. Nevertheless, there are some gaps in terms of long term follow up data, the best choice of material to use in different clinical settings, and what should be done to enhance sealant programs in underserved communities. The review shows that the application of sealants must be incorporated into an overall plan of managing caries and also provides an insight into the future opportunities in material science and policy development.References
Vikl, B., Moritz, A., & Bekes, K. (2018). Pit and fissure sealants—A comprehensive review. Dentistry Journal, 6(2), 18. https://doi.org/10.3390/dj6020018
Wnuk, K., Świtalski, J., Miazga, W., Tatara, T., Religioni, U., & Gujski, M. (2023). Evaluation of the effectiveness of prophylactic sealing of pits and fissures of permanent teeth with fissure sealants: Umbrella review. BMC Oral Health, 23(1), 806. https://doi.org/10.1186/s12903-023-03560-6
Priscilla, S., Gs, P., Mohandoss, S., & Kavitha, M. (2022). Moisture tolerant pit and fissure sealant: A literature review. International Journal of Clinical Pediatric Dentistry, 15(2), 233–239.
Leite, K. L. F., Rodrigues, G. F., Chevitarese, A. B., Magno, M. B., Marañón-Vásquez, G. A., Pintor, A. V. B., et al. (2024). Are pit and fissure sealants effective in preventing and arresting occlusal caries in primary and permanent teeth? An overview of systematic reviews. Journal of Evidence-Based Dental Practice, 24(3), 102010. https://doi.org/10.1016/j.jebdp.2024.102010
American Academy of Pediatric Dentistry. (2016). Evidence-based clinical practice guideline for the use of pit-and-fissure sealants. Pediatric Dentistry, 38(5), 120–136.
Wright, J. T., Crall, J. J., Fontana, M., Gillette, E. J., Nový, B. B., Dhar, V., et al. (2016). Evidence-based clinical practice guideline for the use of pit-and-fissure sealants. Journal of the American Dental Association, 147(8), 672–682.e12. https://doi.org/10.1016/j.adaj.2016.06.001
American Academy of Pediatric Dentistry. (2017). Use of pit-and-fissure sealants. Pediatric Dentistry, 39(6), 156–172.
Paglia, L. (2016). Pit and fissure sealants or fluoride varnishes? European Journal of Paediatric Dentistry, 17(3), 173.
American Academy of Pediatric Dentistry. (2016). Evidence-based clinical practice guideline for the use of pit-and-fissure sealants. Pediatric Dentistry, 38(6), 263–279.
American Academy of Pediatric Dentistry. (2018). Use of pit-and-fissure sealants. Pediatric Dentistry, 40(6), 162–178.
Neusser, S., Krauth, C., Hussein, R., & Bitzer, E. M. (2014). Clinical effectiveness and cost-effectiveness of fissure sealants in children and adolescents with a high caries risk. GMS Health Technology Assessment, 10, Doc02. https://doi.org/10.3205/hta000119
Wright, J. T., Tampi, M. P., Graham, L., Estrich, C., Crall, J. J., Fontana, M., et al. (2016). Sealants for preventing and arresting pit-and-fissure occlusal caries in primary and permanent molars. Journal of the American Dental Association, 147(8), 631–645.e18. https://doi.org/10.1016/j.adaj.2016.06.003
Sreedevi, A., Brizuela, M., & Mohamed, S. (2025). Pit and fissure sealants. In StatPearls. StatPearls Publishing.
Xu, Y., Wu, Q. J., Luo, L. P., & Jin, S. Q. (2018). Evaluation of the clinical effect of fluoride coating combined with pit and fissure sealing on prevention of first permanent molar caries. Shanghai Kou Qiang Yi Xue, 27(3), 298–301.
Wright, J. T. (2018). The burden and management of dental caries in older children. Pediatric Clinics of North America, 65(5), 955–963. https://doi.org/10.1016/j.pcl.2018.05.009
Wright, J. T., Tampi, M. P., Graham, L., Estrich, C., Crall, J. J., Fontana, M., et al. (2016). Sealants for preventing and arresting pit-and-fissure occlusal caries in primary and permanent molars. Pediatric Dentistry, 38(4), 282–308.
Deery, C. (2016). Fissure seal or fluoride varnish? Evidence-Based Dentistry, 17(3), 77–78. https://doi.org/10.1038/sj.ebd.6401184
Riziwaguli, A., Liu, J. Y., Ma, Y. R., & Zou, J. (2014). Pit and fissure sealant for caries prevention in children: Two-year follow-up. Shanghai Kou Qiang Yi Xue, 23(2), 201–203.
Reddy, V. R., Chowdhary, N., Mukunda, K. S., Kiran, N. K., Kavyarani, B. S., & Pradeep, M. C. (2015). Retention of resin-based filled and unfilled pit and fissure sealants. Contemporary Clinical Dentistry, 6(Suppl 1), S18–S23. https://doi.org/10.4103/0976-237X.152939
Ammari, M. M., Soviero, V. M., da Silva Fidalgo, T. K., Lenzi, M., Ferreira, D. M., Mattos, C. T., et al. (2014). Is non-cavitated proximal lesion sealing an effective method for caries control? Journal of Dentistry, 42(10), 1217–1227. https://doi.org/10.1016/j.jdent.2014.07.012
Cianetti, S., Lombardo, G., Bravi, M., & Grandini, S. (2016). Is pit and fissure sealing of buccal surfaces useful in reducing caries incidence? European Journal of Paediatric Dentistry, 17(3), 193–196.
Liu, Y. J., Chang, Q., Rong, W. S., & Zhao, X. L. (2018). Caries prevention effectiveness of resin-based and glass ionomer sealants. Zhonghua Kou Qiang Yi Xue Za Zhi, 53(7), 437–442.
Sridhar, L. P., Moses, J., Rangeeth, B. N., & Sivakumar, S. (2016). Comparative evaluation of the marginal sealing ability of two pit and fissure sealants. Journal of Clinical and Diagnostic Research, 10(9), ZC01–ZC04. https://doi.org/10.7860/JCDR/2016/19157.8458
Ananda, S. R., & Mythri, H. (2014). Fluoride release from two different sealants. Journal of Clinical and Experimental Dentistry, 6(5), e497–e501. https://doi.org/10.4317/jced.51554
Lausch, J., Askar, H., Paris, S., & Meyer-Lueckel, H. (2017). Micro-filled resin infiltration of fissure caries lesions. Journal of Dentistry, 57, 73–76. https://doi.org/10.1016/j.jdent.2016.12.009
Yang, X., Guo, J., Hu, B., Li, Z., Wu, M., Guo, H., et al. (2022). Amyloid-mediated remineralization in pit and fissure for caries preventive therapy. Advanced Healthcare Materials, 11(19), e2200872. https://doi.org/10.1002/adhm.202200872
Smitha, M., Paul, S. T., Nagaraj, T., Khan, A. R., & Rinu, K. (2019). Clinical evaluation of two pit and fissure sealants on permanent mandibular first molars. Journal of Contemporary Dental Practice, 20(10), 1151–1158.
Honkala, S., ElSalhy, M., Shyama, M., Al-Mutawa, S. A., Boodai, H., & Honkala, E. (2015). Sealant versus fluoride in primary molars: One-year randomized clinical trial. Caries Research, 49(4), 458–466. https://doi.org/10.1159/000431324
Schwendicke, F., Jäger, A. M., Paris, S., Hsu, L. Y., & Tu, Y. K. (2015). Treating pit-and-fissure caries: Network meta-analysis. Journal of Dental Research, 94(4), 522–533. https://doi.org/10.1177/0022034515570278
Chen, Y., Chen, D., & Lin, H. (2021). Infiltration and sealing for managing non-cavitated proximal lesions. BMC Oral Health, 21(1), 13. https://doi.org/10.1186/s12903-020-01359-3
Paris, S., Lausch, J., Selje, T., Dörfer, C. E., & Meyer-Lueckel, H. (2014). Comparison of sealant and infiltrant penetration into pit and fissure caries lesions in vitro. Journal of Dentistry, 42(4), 432–438. https://doi.org/10.1016/j.jdent.2013.12.006
Alsabek, L., Al-Nerabieah, Z., Bshara, N., & Comisi, J. C. (2019). Retention and remineralization effect of moisture-tolerant resin-based sealant and glass ionomer sealant on non-cavitated pit and fissure caries: Randomized controlled clinical trial. Journal of Dentistry, 86, 69–74. https://doi.org/10.1016/j.jdent.2019.05.006
Markovic, D., Peric, T., & Petrovic, B. (2018). Glass-ionomer fissure sealants: Clinical observations up to 13 years. Journal of Dentistry, 79, 85–89. https://doi.org/10.1016/j.jdent.2018.10.003
Kielbassa, A. M., Ulrich, I., Schmidl, R., Schüller, C., Frank, W., & Werth, V. D. (2017). Resin infiltration of deproteinised natural occlusal subsurface lesions improves initial quality of fissure sealing. International Journal of Oral Science, 9(2), 117–124. https://doi.org/10.1038/ijos.2017.19
Liu, Y., Rong, W., Zhao, X., Wang, M., Jiang, Q., & Wang, W. (2014). Caries prevention effect of resin-based sealants and glass ionomer sealants. Zhonghua Kou Qiang Yi Xue Za Zhi, 49(4), 199–203.
Bakhshandeh, A., & Ekstrand, K. (2015). Infiltration and sealing versus fluoride treatment of occlusal caries lesions in primary molar teeth: 2–3-year results. International Journal of Paediatric Dentistry, 25(1), 43–50. https://doi.org/10.1111/ipd.12096
Cornea, D., Oprean, R., & Dudea, D. (2014). The use of dental sealing in Cluj, Romania: Frequency, materials and techniques—A questionnaire study. Clujul Medical, 87(3), 182–185.
de Assunção, I. V., da Costa, G. F., & Borges, B. C. D. (2014). Systematic review of noninvasive treatments to arrest dentin non-cavitated caries lesions. World Journal of Clinical Cases, 2(5), 137–141. https://doi.org/10.12998/wjcc.v2.i5.137
Ahovuo-Saloranta, A., Forss, H., Walsh, T., Nordblad, A., Mäkelä, M., & Worthington, H. V. (2017). Pit and fissure sealants for preventing dental decay in permanent teeth. Cochrane Database of Systematic Reviews, (7), CD001830. https://doi.org/10.1002/14651858.CD001830.pub5
Fei, X., Li, Y., Weir, M. D., Baras, B. H., Wang, H., Wang, S., Sun, J., Melo, M. A. S., Ruan, J., & Xu, H. H. K. (2020). Novel pit and fissure sealant containing nano-CaF₂ with fluoride release and antibacterial function. Dental Materials, 36(9), 1241–1253. https://doi.org/10.1016/j.dental.2020.06.015
