Evidence map›Paper›PMID 39154643›Full record

Observational studyCaries research2025

Adoption and Effect of Sealants for Occlusal Noncavitated Caries in a Large Dental Network in the USA.

Nilesh H Shah, Jeffrey L Fellows, Deborah E Polk

Abstract readObservational Study
In one paragraph

Observational study in Caries research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Nilesh H ShahDental Public Health, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA.
Jeffrey L FellowsCenter for Health Research, Kaiser Permanente, Portland, Oregon, USA.
Deborah E PolkDental Public Health, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA.

Funding

An implementation strategy for the adoption of an evidence-based pit-and-fissure sealant guideline by salaried dental providers: Using a framework from organizational developmentU01DE027452 · NIDCR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI POLK, DEBORAH E · 2017 to 2021
$2.6M
NIDCR NIH HHS U01 DE027452
6 · The paper itself

Abstract

introductionDental sealants applied to occlusal pit-and-fissure surfaces have been shown to prevent caries and arrest occlusal noncavitated carious lesions (NCCLs). The American Dental Association (ADA) recommends that oral healthcare providers apply sealants on occlusal NCCLs. Though the evidence is clear that sealants are effective, few studies have examined the adoption of the ADA guideline by dentists and the duration of protection provided by sealants in a large real-world setting.

methodsThis study used observational electronic health record (EHR) data from a network of dental clinics to follow teeth over a 2 year time period from when they were diagnosed as having an occlusal NCCL until either they were treated with a restoration or the time period ended with no restoration. The objectives of the study were to determine: (1) the degree to which dentists adopted the guideline, (2) whether the duration of protection was different for teeth that received a sealant from teeth that did not receive a sealant, and (3) whether dentists' experience placing sealants was associated with the duration of protection.

resultsOverall, there were 7,299 teeth in the sample. Of those, dentists restored 591 teeth and applied sealants on 164. The sealant application rate for eligible teeth was 2.2%. Sealant application was associated with provider, with 1.9% of providers placing more than half of the sealants. By the end of the observation period, the proportion of teeth progressing to restorations was 8.2% for teeth that had not received a sealant and 3.0% for teeth that had received one (RR = 0.37; 95% CI: 0.16-0.88; p = 0.02). Multilevel survival analysis showed that teeth that had not received a sealant were restored sooner than teeth that had received a sealant (aHR = 0.11; 95% CI: 0.03-0.36; p < 0.01). Overall, teeth that received a sealant had an 89% reduced hazard of restoration within 2 years compared with teeth that did not receive sealants.

conclusionThis study found that by arresting decay, the presence of sealants led to fewer restorations and delayed restorations compared with teeth not receiving a sealant or restoration in the 2 years following diagnosis of occlusal NCCL in clinical settings.

Indexed as

Dental CariesGuideline AdherencePit and Fissure SealantsPractice Patterns, Dentists'AdultDental Restoration, PermanentElectronic Health RecordsFemaleHumansMaleMiddle AgedUnited StatesPit and Fissure SealantsIncipient cariesNoncavitated carious lesionRestorationsSealantsSurvival analysis

Identifiers

PMID39154643
PMCPMC11790370

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.