NIH Funds Oral Health Research Institute Study of Dental Sealants
Dental sealants have long been an effective tool in preventive dentistry, and their use through school-based initiatives such as the Indiana University School of Dentistry's statewide SEAL INDIANA program has helped bring low-cost preventive care to underserved populations at high risk for dental disease.
However, methods are needed to ensure that if the surfaces of the teeth are covered by dental sealants, they can continue to be reliably monitored for the development and/or progression of dental caries (decay).
"Research has shown that caries in its early stages can be sealed without harming the tooth, and that sealants are in fact a very effective means of stopping the disease's progression," says Dr. Margherita Fontana, IU associate professor of preventive and community dentistry. "The problem is that 'early' caries has not yet been clearly defined or uniformly agreed upon, so that leaves dentists without practical guidelines to use in their practices. Research is needed to help determine which tooth surfaces are the most appropriate to seal, what amount of decay can be safely sealed, and which sealants do the most effective job of protecting teeth."
Fontana will use a recently awarded grant of $416,625 from the National Institutes of Health's National Institute of Dental and Craniofacial Research to conduct a two-year exploratory study. As the principal investigator, she will work with a team of researchers at the IU dental school's Oral Health Research Institute to look at dental sealants' effectiveness at arresting decay, and to evaluate the ability of new techniques in caries detection to pinpoint and monitor decay when it occurs underneath dental sealants.
The researchers will seek the assistance of northern Indiana's Amish community in choosing the study's participants. Representatives from that community will serve on an advisory board for the duration of the study.
The IU dental school has had a long association with the Amish people of Indiana. Through one of the school's Community Dentistry programs, faculty and students have been traveling to Shipshewana, near Elkhart, since 1996 to help provide dental care to economically disadvantaged Amish children from the surrounding area.
"We are interested in further developing the partnership," says Fontana. "The state's Amish population is extremely underserved, and has major dental needs."
Beginning in 2008, the researchers will place dental sealants on the permanent molars of 60 Amish schoolchildren in grades two through four and then monitor the development and progression of dental disease in the youngsters for one year.
The team will use a new clinical (visual) assessment technique called the International Caries Detection and Assessment System (ICDAS) to determine caries prevalence and incidence as well as the severity of carious lesions. Designed by a global team of scientists including dental researchers at IU, ICDAS proposes a new international criteria standard to help dentists and researchers accurately and reliably assess early caries by visual means. The results of the ICDAS technique will be compared to those obtained by traditional radiography and two currently marketed diagnostic imaging instruments.
"Our long-term goals are to determine the effectiveness of dental sealants in managing different stages of the caries process," says Fontana, "and, ultimately, to help equip dentists with evidence and techniques they can use in their practices to make the best preventive treatment decisions for their patients."
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