Glass Ionomer Sealant Versus Fluoride Varnish on Occlusal Caries Prevention
Glass Ionomer Sealant Versus Fluoride Varnish on Occlusal Caries Prevention
The current study compares the efficacy of glass ionomer fissure sealant versus topical
 application of 5% sodium fluoride varnish in prevention of occlusal caries among preschool
 children.
Topical fluoride varnish (TFV) with 5% sodium fluoride in its content has proven effective in
 preventing caries among children and adolescents. Its reduction in DMFT is well supported by
 Cochrane reviews and clinical trials. However, its effect in preventing pit and fissure
 caries in primary dentition has not been assessed.

 Pit and fissure sealants have been a recommended procedure in preventing caries development
 in permanent molars. Multiple systematic reviews and clinical trials have concluded that
 fissure sealants are significantly more effective than topical fluoride varnishes in
 preventing occlusal caries in permanent molars. However, a recent Cochrane review suggested
 that there was still insufficient evidence to determine superiority of resin or glass ionomer
 fissure sealants over topical fluoride varnishes for occlusal caries prevention, due to the
 lack of reliable results and low quality of evidence.

 Also, most studies were conducted on permanent first molars among school children, whom
 cooperation and moisture control can be easily achieved. However, application of fissure
 sealants, especially resin-based sealant, in very young children can be a technique-sensitive
 procedure. Compared with a mean treatment time of less than 3 minutes for varnish
 application, application of resin-based sealants required over 15 minutes. Moisture control
 is also of paramount importance for the retention and success of resin-based sealants, which
 may be difficult among young preschool children.

 Glass-ionomer sealants can chemically bond to enamel and are more tolerable to inadequate
 moisture control. As its application requires less clinical steps, glass-ionomer sealant is
 comparatively more acceptable to younger patients and can be used in outreach settings with a
 large number of participants. The fluoride releasing ability is also beneficial in preventing
 caries especially at adjacent tooth surfaces. However, its retention rate is significantly
 lower than that of resin-based sealants, its success rate in preventing fissure caries in
 very young patients is still unknown.
Inclusion Criteria:

 Generally healthy children aged between 3-5 years with no remarkable medical history.

 Exclusion Criteria:

 1. Children with the presence of caries of ICDAS code 3, 4, 5, or 6 on other primary
 teeth.

 2. Children who had received professional fluoride application in the past 6 months.

 3. Children with serious systemic disease or taking long term medication.

 4. Children who are uncooperative or refuse the treatment.

 5. Second primary molars that are (i) with caries in dentin indicated by ICDAS code 4, 5
 or 6; (ii) partially erupted; (iii) with fillings and/or sealants; and (iv)
 hypoplastic or hypomineralized.