Pit and fissure sealants applied after permanent molars emerge

Each application costs just a few dozen to a couple of hundred yuan — specifically, between 100 and 200 yuan per tooth. No anesthesia is needed, no tooth grinding is required, and the whole procedure takes only a few minutes. Many regions offer free sealant programs for children who meet the age criteria.

A Cochrane systematic review synthesized 38 trials involving 7,924 children aged 5 to 16 years, comparing resin-based sealants with no sealant. For the first permanent molars of children aged 5 to 10 years, the odds ratio (OR) for developing dental caries at 24 months was 0.12 (95% CI 0.08–0.19). This estimate came from 7 trials with 1,548 children randomized and 1,322 evaluated, representing moderate-quality evidence. An odds ratio cannot be directly treated as the ratio of cavity percentages between the two groups. The actual risk reduction depends on how many teeth would otherwise decay without sealant. At 48 to 54 months, the odds ratio was OR 0.21 (0.16–0.28), with sealed teeth still developing fewer cavities. The authors concluded that resin-based sealants prevent caries better than no sealant at 24 months. Across 4 trials that reported adverse events, none occurred. There is insufficient evidence to determine which sealant material is superior among other types such as glass ionomer.

Ahovuo-Saloranta A, et al. (2017). Pit and fissure sealants for preventing dental decay in permanent teeth. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD001830.pub5

The first permanent molars (the big back teeth that do not fall out) usually erupt around age 6, and the second around age 12. Sealants should be applied soon after the teeth emerge before any decay begins; once a tooth is already decayed, it can only be filled. Many regions include sealants for age-eligible children as a free public program; consult your local Chinese CDC or community health service center. Because no verbatim verifiable nationwide document was identified, specific coverage areas and age brackets are omitted here. The Cochrane summary also cited several examples of percentage differences between groups, but back-calculating from the odds ratios did not match up, so they were not copied here. Tooth decay is also a priority guidance item in student physical checkups; see Item 7.