Caries prevention for kids

Sealants fit the chewing grooves of primary or permanent molars that are sound or have early decay without a cavity. They reduce decay on these occlusal surfaces and can be used with other prevention.

Fluoride varnish is one topical fluoride option. Fluoride care can also include toothpaste, mouthrinse, gel or foam, while water and dietary fluoride add to a child’s total exposure.

The useful comparison here is prevention rather than a stated price: trials found a 73% lower incidence of occlusal lesions with sealants than with varnish after two to three years in sound permanent molars.

The head-to-head evidence follows children for two to three years. A sealant may be partly or fully lost, yet studies did not find more caries in those teeth than in teeth that had never been sealed.

Two trials reported no sealant-related adverse events, and the brief exposure to the small amount of BPA in some sealants was not found to put patients at risk. Excess fluoride swallowed during early tooth development can contribute to fluorosis.

Neither option repairs a cavity. The sealant comparison applies to sound chewing surfaces and noncavitated lesions, while fluoride is part of prevention and caries control rather than a filling material.

Start with the surface: sealants target pits and fissures on molars. Then account for whether decay has formed a cavity, the child’s caries risk, and fluoride already coming from water, diet and home products.