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The success of fissure sealants placed by dentists and dental care professionals.

OBJECTIVE
To obtain preliminary data on the effectiveness of fissure sealants placed by dentists and dental care professionals (DCPs).


RESEARCH DESIGN
Case-note review of fissure sealants provided for paediatric patients within primary dental services in South Yorkshire.


PARTICIPANTS
Records were retrieved for 1,100 fissure sealants, placed on first and second permanent molars of 312 children by 25 participating dentists and 25 DCPs during 2001-2003.


MAIN OUTCOME MEASURES
Independent variables included operator details and patient-related factors including: caries experience at baseline, age, gender, and socio-economic status. The outcome variables were sealant retention and progression to caries at three years. Bivariate analyses were used to explore the role of potential factors associated with the success of fissure sealant survival. Kaplan-Meier survival analysis and Cox's regression models were used to estimate the probability of sealant success for both operator groups.


RESULTS
Retention rates at three years for fissure sealants placed by dentists and DCPs were 62.4% (SD = 22.1) and 58.1% (SD = 21.5) respectively. After three years, 87.1% (SD = 9.8) and 84.2% (SD = 11.6) of teeth sealed by dentists and DCPs remained sound. Exploratory analysis found no significant difference in sealant retention or caries transformation rates according to operator type.


CONCLUSIONS
On the basis of these preliminary findings, delegation of fissure sealants to DCPs would seem to be justified in view of the comparable sealant success rates achieved by dentists and DCPs. These data can now be used to inform future randomised controlled trials on the effectiveness of fissure sealants by different operator groups.