The effectiveness of fissure sealing in preventing dental caries in a subject-specific fashion was studied in order to forge a link between the controlled trials and knowledge creation in clinical practice.
The subjects were divided retrospectively into three categories according to the sealant treatment status of their first permanent molars at the first examination after the eruption and the survival of first molars in each group were estimated using the Kaplan-Meier method.
Sealing of all first molars in caries-prone subjects was an effective caries preventive method. The highest survival of first molars was observed in the unsealed subjects in the health center focusing on sealing risk-subjects only. The first molars of partly sealed subjects had the lowest probability of survival in both health centers.
Sealing all four permanent first molars rather than some of them in high caries risk subjects and leaving unsealed the first molars of caries resistant subjects enable to decrease unnecessary sealant treatment by focusing it especially to those benefiting it.