Pit-and-Fissure Sealants

Publication Date: October 1, 2016
Last Updated: March 14, 2022


The sealant guideline panel recommends the use of sealants compared with nonuse in permanent molars with both sound occlusal surfaces and noncavitated occlusal carious lesions in children and adolescents.* (ModerateStrong)

The sealant guideline panel suggests the use of sealants compared with fluoride varnishes in permanent molars with both sound occlusal surfaces and noncavitated occlusal carious lesions in children and adolescents.* (LowConditional (weak))

The panel was unable to determine superiority of 1 type of sealant over another owing to the very low quality of evidence for comparative studies. The panel recommends that any of the materials evaluated (for example, resin-based sealants, resin-modified glass ionomer sealants, glass ionomer cements, and polyacid-modified resin sealants, in no particular order) can be used for application in permanent molars with both sound occlusal surfaces and noncavitated occlusal carious lesions in children and adolescent.*† (Very LowConditional (weak))

* These recommendations are applicable to both sound surfaces and noncavitated carious lesions: “Noncavitated lesions are characterized by a change in color, glossiness, or surface structure as a result of demineralization before there is macroscopic breakdown in surface tooth structure. These lesions represent areas with net mineral loss due to an imbalance between demineralization and remineralization. Reestablishing a balance between demineralization and remineralization may stop the caries disease process while leaving a visible clinical sign of past disease.”
† The guideline panel suggests that clinicians should take into account the likelihood of experiencing lack of retention when choosing the type of sealant material most appropriate for a specific patient and clinical scenario. For example, in situations in which dry isolation is difficult, such as a tooth that is not fully erupted and has soft tissue impinging on the area to be sealed, then a material that is more hydrophilic (for example, glass ionomer) would be preferable to a hydrophobic resin-based sealant. On the other hand, if the tooth can be isolated to ensure a dry site and long-term retention is desired, then a resin-based sealant may be preferable.

Recommendation Grading



Use of Pit-and-Fissure Sealants

Authoring Organization

Publication Month/Year

October 1, 2016

Last Updated Month/Year

January 16, 2024

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Document Objectives

This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pitsand-fissures of occlusal surfaces. 

Target Patient Population

Child and Adlescents

Inclusion Criteria

Female, Male, Adolescent, Child

Health Care Settings

Childcare center, Outpatient, School

Intended Users

Dentist, dental other, dentist pediatric dentistrydentist, dental other, nurse, nurse practitioner, physician, physician assistant



Diseases/Conditions (MeSH)

D003731 - Dental Caries, D010895 - Pit and Fissure Sealants


Pit and fissure sealants, fluori

Source Citation


Supplemental Methodology Resources

Systematic Review Document