Glass-ionomer sealant or fluoride varnish?: Efficacies in occlusal caries prevention among preschool children – A 18-24 months randomized controlled trial

Abstract

Background: The study evaluated the efficacies of glass-ionomer sealant (GIS) versus professionally-applied 5% sodium fluoride varnish (NaFV) in the prevention and arrest of occlusal caries in primary second molars among preschool children.

Methods: Children with at least one sound primary second molar or with non-cavitated enamel caries lesions were randomly allocated to either NaFV group – application of 5% NaFV at quarterly; or GIS group - one single placement of GIS. Both groups were examined at baseline and biannually thereafter by two blinded examiners.

Results: At baseline, the respective preventive measures were performed on 323 children with 1,159 primary second molars. At 18-24 months, 263 children (81.4%) with 965 molars (83.2%) remained in the study. Caries had developed or progressed into dentin in 62 (12.4%) of the molars in NaFV group, and 48 (10.4%) in GIS group, with no significant difference between the groups (p = 0.201). The overall retention rates of GIS were 24.6%, 13.5% and 13.1% at 6, 12 and 18 months, respectively. Quarterly NaFV application and single GIS placement demonstrated no significant difference in the prevention and arrest of occlusal caries in primary second molars among preschool children. Baseline caries experience and household income were identified to significantly influence the progression of occlusal caries at 18-24 months, while other sociodemographic factors and clinical findings had no significant association.