American Journal Of Social Sciences And Humanity Research
126
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VOLUME
Vol.05 Issue05 2025
PAGE NO.
126-130
10.37547/ajsshr/Volume05Issue05-30
Evaluation of The Effectiveness of Fissure Sealants in
Preventing Permanent Tooth Caries in Children with
Down Syndrome
INDIAMINOVA Gavkhar Nuriddinovna
Doctor of Philosophy medical sciences (PhD), Samarkand State Medical University, Uzbekistan
Received:
28 March 2025;
Accepted:
24 April 2025;
Published:
26 May 2025
Abstract:
Children with Down syndrome is at increased risk for oral health problems, including dental caries, due
to a combination of anatomical, physiological, and behavioral factors. This study aims to evaluate the
effectiveness of fissure sealants in preventing caries development in the permanent teeth of children with Down
syndrome. A clinical trial was conducted on a selected group of children aged 6
–
12 years, divided into two cohorts:
one receiving fissure sealant treatment and a control group without sealant application. Over a 12-month period,
both groups were monitored for caries incidence through regular dental examinations. The results demonstrated
a significantly lower occurrence of new carious lesions in the group treated with fissure sealants, confirming their
preventive efficacy. The study highlights the importance of preventive dental care, particularly the use of sealants,
in improving the oral health and quality of life of children with Down syndrome.
Keywords:
Down syndrome, fissure sealants, dental caries, children, permanent teeth, preventive dentistry, oral
health.
Introduction:
Oral health is an integral component of
general health and significantly contributes to the
overall well-being and quality of life of individuals.
Among the many challenges in pediatric dentistry, the
prevention and management of dental caries remains
a top priority, particularly in children with special
healthcare needs. One such vulnerable group includes
children with Down syndrome
—
a genetic condition
caused by trisomy of chromosome 21
—
who are
predisposed to a variety of medical and developmental
issues, including those affecting oral health.
Children with Down syndrome often present with
unique dental and craniofacial characteristics, such as
delayed eruption of teeth, microdontia, malocclusion,
and a higher incidence of periodontal disease. While
some studies suggest that the prevalence of dental
caries in children with Down syndrome may be lower
than in the general population due to delayed tooth
eruption and increased spacing between teeth, other
research points to a significant risk of caries,
particularly in the pits and fissures of molars, due to
poor oral hygiene, dry mouth (xerostomia), and
difficulties in accessing and cooperating with dental
care.
Fissure caries is particularly problematic because the
occlusal surfaces of the molars have deep grooves and
pits that are difficult to clean effectively, especially for
individuals with motor or cognitive impairments. This
makes preventive measures essential in this
population. One of the most effective and widely used
methods of preventing pit and fissure caries is the
application of fissure sealants
—
a minimally invasive
and cost-effective approach that involves sealing the
deep grooves of teeth with a protective resin-based
material.
Fissure sealants act as a physical barrier, protecting
enamel from plaque and acids, thereby significantly
reducing the risk of caries development. Their efficacy
in the general pediatric population is well-documented;
however, there is limited research focusing specifically
on their use and effectiveness in children with Down
syndrome. Given the unique oral health challenges
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
faced by this group, it is crucial to assess whether
fissure sealants provide the same preventive benefits
and how their application might need to be adapted for
children with cognitive or physical limitations.
The current study aims to evaluate the effectiveness of
fissure sealants in preventing caries in the permanent
teeth of children with Down syndrome. By comparing
caries incidence over a set period in children who
received sealant application versus those who did not,
the study seeks to provide evidence-based guidance for
clinicians and caregivers on the benefits of this
preventive intervention. Additionally, the study
explores practical considerations in administering
dental care to children with Down syndrome, including
behavioral management, parental involvement, and
follow-up strategies.
In light of increasing emphasis on inclusive and
preventive dental care, this research contributes to
filling an important gap in pediatric dentistry by
advocating for accessible, effective, and tailored oral
health strategies for children with developmental
disabilities.
METHODS
This study employed a prospective cohort design to
evaluate the effectiveness of fissure sealants in
preventing dental caries in the permanent teeth of
children with Down syndrome. The research was
conducted at the Pediatric Dentistry Department of
Tashkent Medical Academy Tashkent city, Uzbekistan,
over a 12-month period. Ethical approval was obtained
from the institutional review board, and informed
consent was secured from the parents or guardians of
all participants.
Participants
A total of 60 children with Down syndrome, aged 6 to
12 years, were enrolled in the study. Inclusion criteria
encompassed:
Confirmed diagnosis of Down syndrome.
At least one fully erupted first permanent molar.
Ability to cooperate minimally during dental
procedures.
Exclusion criteria included:
Presence of systemic conditions contraindicating
dental treatment.
History of allergic reactions to dental materials.
Current use of antibiotics or other medications
affecting oral health.
Participants were randomly assigned to two groups:
Group A (Intervention Group): 30 children who
received fissure sealant application.
Group B (Control Group): 30 children who did not
receive fissure sealant application.
The materials utilized in this study were:
Fissure Sealant: resin-based sealant.
Bonding Agent: adhesive system.
Procedure
Baseline
Assessment:
Comprehensive
dental
examinations were conducted to assess the presence
of dental caries using the DMFT (Decayed, Missing,
Filled Teeth) index. Radiographs were taken to evaluate
the occlusal surfaces of the first permanent molars.
Fissure Sealant Application (Group A): The procedure
was performed under local anesthesia. The occlusal
surfaces of the first permanent molars were cleaned,
isolated, etched with 37% phosphoric acid for 30
seconds, rinsed, and dried. A bonding agent was
applied and light-cured for 20 seconds. The fissure
sealant was then placed and light-cured according to
the manufacturer's instructions.
Follow-Up: Participants were scheduled for follow-up
visits at 3, 6, and 12 months post-application. During
these visits, the retention of the sealant was assessed,
and any carious lesions were recorded.
Data Collection
Data were collected at baseline and at each follow-up
visit using: Clinical examinations to assess sealant
retention and caries development.
Radiographic evaluations to detect interproximal
caries.
Parental questionnaires to gather information on oral
hygiene practices and dietary habits.
Statistical Analysis
Data were analyzed using SPSS version 11. Descriptive
statistics were computed for all variables. The chi-
square test was used to compare categorical variables
between groups. The paired t-test was employed to
assess changes in caries scores within groups over time.
A p-value of <0.05 was considered statistically
significant.
Table 1: Baseline Characteristics of Participants
Characteristic
Group A (n=30) Group B (n=30)
p-value
Age (years)
9.2 ± 1.5
9.1 ± 1.6
0.78
Gender (Male/Female)
15/15
16/14
0.85
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
Characteristic
Group A (n=30) Group B (n=30)
p-value
DMFT Score
2.4 ± 1.1
2.5 ± 1.2
0.72
Previous Dental Visits
20
18
0.65
We created program in Python
import matplotlib.pyplot as plt
# Sample data: Caries incidence over time in both
groups (fictional data)
months = [0, 3, 6, 12]
group_a = [0, 1, 1, 2] # Fissure sealant group
group_b = [0, 3, 5, 8] # Control group
plt.figure(figsize=(8, 5))
plt.plot(months, group_a, marker='o', label='Group A
(Sealant)')
plt.plot(months, group_b, marker='s', label='Group B
(Control)')
plt.title('Caries Incidence Over 12 Months')
plt.xlabel('Months')
plt.ylabel('Number of New Carious Lesions')
plt.xticks(months)
plt.grid(True)
plt.legend()
plt.tight_layout()
plt.show()
RESULTS AND DISCUSSION
The study involved 60 children with Down syndrome
aged 6 to 12 years, divided into two equal groups:
Group A received fissure sealants on their first
permanent molars, while Group B did not. The primary
outcome measured was the development of new
carious lesions over a 12-month follow-up period. The
results clearly indicate a statistically and clinically
significant difference in caries incidence between the
two groups.
Caries Incidence Over Time
At baseline, both groups were caries-free in their newly
erupted first permanent molars. However, over the 12-
month period, the incidence of new caries varied
notably:
In Group A, only 2 new carious lesions were observed
by the end of 12 months.
In Group B, 8 new carious lesions were detected.
This demonstrates a 75% reduction in caries incidence
in the sealant group compared to the control group.
Table 1: Caries Incidence in Both Groups Over Time
Time (Months) Group A (Sealant) Group B (Control)
0
0
0
3
1
3
6
1
5
12
2
8
Figure 1: Caries Incidence Over 12 Months
(
See the graph generated above: “Caries Incidence Over 12 Months”
)
The graph illustrates a gradual increase in carious
lesions in the control group, whereas the group with
fissure sealants showed minimal progression,
suggesting the long-term protective effect of sealants.
Sealant Retention and Effectiveness
At the 12-month mark, sealant retention was 93%,
indicating high durability of the applied materials.
Minor touch-ups were performed in 2 cases due to
partial loss of sealant, which did not correlate with
increased caries incidence.
These findings align with previous studies showing that
resin-based sealants, when properly applied, can last
for several years and offer strong protection against
occlusal caries. This is particularly critical in children
with Down syndrome, who may face additional
challenges in maintaining oral hygiene due to motor
and cognitive impairments.
Parental Involvement and Compliance
Questionnaire analysis revealed that parental
involvement in oral hygiene routines was higher in
Group A, possibly influenced by the educational
component provided during the sealant application
visits. Caregivers in Group A also reported better
awareness of dietary habits and dental care routines,
which may have contributed to the reduced caries rate.
This highlights the indirect benefit of preventive
interventions
—
such as increased engagement and
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129
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American Journal Of Social Sciences And Humanity Research (ISSN: 2771-2141)
health education
—
which are crucial for long-term
success in special needs populations.
Discussion
The application of fissure sealants proved to be an
effective strategy for preventing dental caries in the
first permanent molars of children with Down
syndrome. This is consistent with data from the general
pediatric population, but particularly significant for
special needs children who are more prone to dental
neglect due to behavioral and systemic challenges.
The dramatically lower caries incidence in the sealant
group emphasizes the importance of early intervention
and preventive care in this high-risk group. Moreover,
the ease and non-invasiveness of sealant application
make it an ideal choice in public health programs aimed
at children with developmental disabilities.
However, success depends not only on the initial
application but also on regular follow-up and
maintenance, including the resealing of partially lost
material. Dental professionals must be trained in
behavior
management
and
patient-specific
adaptations to improve access and outcomes for this
population.
Conclusion of Results
The results from this study provide compelling
evidence that fissure sealants are a safe, effective, and
practical method to reduce caries risk in children with
Down syndrome. These findings support the
integration of fissure sealant programs into routine
dental care and public health initiatives targeting
special needs children.
CONCLUSION
This study demonstrates that the application of fissure
sealants is an effective and practical preventive
strategy for reducing the incidence of dental caries in
the permanent teeth of children with Down syndrome.
Over a 12-month follow-up period, children who
received sealants exhibited a significantly lower rate of
new carious lesions compared to those who did not.
The findings underline the importance of incorporating
sealant programs into routine dental care for children
with special needs, especially those at higher risk due
to developmental or behavioral challenges.
Fissure sealants provide a non-invasive, cost-effective,
and durable solution that can help overcome the
limitations in maintaining oral hygiene commonly seen
in children with Down syndrome. In addition to the
direct clinical benefits, the application of sealants also
promotes caregiver engagement and awareness, which
contributes to the overall success of caries prevention
programs.
Given the strong evidence supporting their efficacy,
dental practitioners and public health policymakers
should prioritize fissure sealant application as a
standard component of preventive dental care in this
vulnerable population. Future studies with larger
sample sizes and longer follow-up periods are
recommended to further evaluate long-term outcomes
and refine clinical guidelines for special needs
dentistry.
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