The Effectiveness of Fluoride Varnish and Fissure Sealant in  Elementary School Children: A Systematic Review and  Meta-Analysis

Dariush  Jafarzadeh; Ramin  Rezapour; Teimour  Abbasi; Jafar Sadegh Tabrizi; Maryam  Zeinolabedini; Assef  Khalili; Mahmood  Yousefi

doi:10.18502/ijph.v51i2.8680

Dariush Jafarzadeh Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
Ramin Rezapour Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
Teimour Abbasi Tabriz Dentistry Hospital, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
Jafar Sadegh Tabrizi Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
Maryam Zeinolabedini Department of Basic Sciences, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
Assef Khalili Department of Basic Sciences, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
Mahmood Yousefi Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

DOI: https://doi.org/10.18502/ijph.v51i2.8680

Keywords: Fluoride varnish; Fissure sealant; Systematic review; Meta-analysis; Oral health

Abstract

Background: Highly necessary to evaluate the effectiveness of preventive interventions to prioritize them at the community level. We aimed to systematically investigate the related studies on the effects of fluoride varnish and fissure sealant on dental caries in 6-12 children.

Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library and Scopus databases using Fluoride Varnish, Fissure Sealant, Caries, and Oral Health keywords. The timeframe selected to search for articles is from 2000 to Dec 2020. CMA software: 2 (Comprehensive Meta-Analysis) was used to perform the meta-analysis. The intervention groups in this study were fluoride varnish and fissure sealants, each of them compared to the control groups.

Results: We included nine studies. In the intervention group 84,380 and control group 11,254 individuals were studied. Eight of the studies were Randomized Clinical Trial (RCT) and Field RCT, and two was non-RCT. In the overall Fluoride Varnish efficacy study, 4 were fully effective, 1 was ineffective, and all 4 were completely effective for Fissure Sealant. There was a significant difference between decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled primary teeth (dmft) indices in both interventions and comparison groups. Moreover, the mean difference of DMFT for Fluoride Varnish and Fissure Sealant in the intervention and control groups were -0.55 and -0.29, respectively (P=0.00).

Conclusion: Due to the efficacy of fissure sealant and fluoride varnish in preventing dental caries in children aged 6-12 yr, these interventions can be considered as health priorities of societies and health systems interventions in countries.