Fluoride varnish vs Fissure sealant (resin-based or glass ionomer): Caries incidence of first permanent molars (FPMs)
- Population
- Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures or early enamel caries (ICDAS 0-3)
- Intervention
- Fluoride varnish
- Comparison
- Fissure sealant (resin-based or glass ionomer)
- Outcome
- Caries incidence of first permanent molars (FPMs)
After excluding the high-risk-of-bias study (Bravo 1996), fluoride varnish and fissure sealant did not differ in caries incidence of FPMs and heterogeneity fell to 0% (RR 1.05, 95% CI 0.91 to 1.22; 5 RCTs; ungraded).
What each review found
Current versions only| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
Fluoride varnish applied biannually vs Fissure sealant (resin-based or glass ionomer) Caries incidence of first permanent molars (FPMs) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures… · 2 to 3 years, Sensitivity analysis excluding Bravo 1996 (high risk of bias) After excluding the high-risk-of-bias study (Bravo 1996), fluoride varnish and fissure sealant did not differ in caries incidence of FPMs and heterogeneity fell to 0% (RR 1.05, 95% CI 0.91 to 1.22; 5 RCTs; ungraded). Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a… (2020) All outcomes | RR 1.05 [0.91, 1.22] | 5 studies | GRADE not reported |
Fluoride varnish applied biannually vs Fissure sealant (resin-based or glass ionomer) Caries incidence of first permanent molars (FPMs) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures… · 2 to 3 years Fluoride varnish and fissure sealant did not differ significantly in caries incidence of first permanent molars at 2 to 3 years (RR 1.29, 95% CI 0.95 to 1.75; 6 RCTs; ungraded). Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a… (2020) All outcomes | RR 1.29 [0.95, 1.75] | 6 studies · 6878 participants | GRADE not reported |
Fluoride varnish applied biannually vs Fissure sealant (resin-based or glass ionomer) Caries incidence of first permanent molars (FPMs) · Generally healthy children aged 6 to 9 years with at least one fully erupted first permanent molar with deep fissures… · 2 to 3 years, Sensitivity analysis excluding split-mouth design (Raadal 1984) Excluding the split-mouth trial (Raadal 1984) did not change the finding of no significant difference in caries incidence of FPMs (RR 1.29, 95% CI 0.88 to 1.87; 5 RCTs; ungraded). Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a… (2020) All outcomes | RR 1.29 [0.88, 1.87] | 5 studies | GRADE not reported |
Findings are shown side by side, never pooled across reviews.
The reviews
| Review | Searched up to | Included studies | AMSTAR 2 |
|---|---|---|---|
| Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a Systematic Review and… 2020 All outcomes | February 2018 | 7 | Critically Low / Critically Low |
Studies behind the findings
The primary studies the full-text reviews tie to this outcome. Reviews with headline outcomes only do not list them here.
- Fissure sealing of permanent first molars in children receiving a high standard of proaphylactic care · 1984 · included by 1 of these review
How reviews are matched to this question
Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.