Summary of findings for the main comparison. Resin‐based fissure sealant compared with fluoride varnish for preventing dental caries.
| Resin‐based fissure sealant compared with fluoride varnish for preventing dental caries | ||||||
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Patient or population: children and adolescents
Settings: sealant and fluoride varnish applications for school children in China, Norway and Spain
Intervention: resin‐based fissure sealant applications on occlusal tooth surfaces of permanent first molars Comparison: fluoride varnish applications on occlusal tooth surfaces of permanent first molars | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Fluoride‐varnished teeth | Sealed teeth | |||||
| Dentine caries in permanent molars Follow‐up: 2 years | Incidence of carious first molars (13.2%) 132 per 1000 | Incidence of carious first molars (9.5%) 95 per 1000 (70 to 125) |
OR 0.69 (95% CI 0.50 to 0.94) | 369 children randomly assigned, 358 evaluated after 2 years (2 studies)a,b | ⊕⊕⊝⊝ Lowc | Benefits of resin sealant over fluoride varnish also found at 4 years and 9 years of follow‐upd No adverse events of interventions reported (2 studies) |
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) CI: Confidence interval; RR: Risk ratio; OR: Odds ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Very low quality: We are very uncertain about the estimate | ||||||
aOne split‐mouth study at high risk of bias conducted in the 1980s (Raadal 1984), and one parallel‐group study at unclear risk of bias conducted in 2008 (Liu 2012).
bIn the Raadal 1984 study, fluoride rinsing programme with 0.5% NaF (sodium fluoride) solution at school.
cDowngraded by two levels because of concerns about the applicability of the results to today's populations. We did not downgrade evidence on the basis of overall risk of bias classifications of the two studies because these studies were otherwise well conducted even though they were not graded as having overall low risk of bias because the blinding of outcome measurement was incomplete. The incomplete blinding of outcome measurement was judged not to be a fundamental issue in assessing the quality of evidence in preventive sealant studies.
dOne Spanish study conducted in the 1990s (Bravo 2005) with risk ratio (RR) of 0.42 (95% confidence interval (CI) 0.21 to 0.84) and RR of 0.48 (95% CI 0.29 to 0.799) at four years and nine years of follow‐up, respectively. The study was assessed as having high risk of bias.