Early Fissure Sealant High Risk — ORE Part 1 MCQ

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EasyPaediatric DentistryEarly Fissure Sealant High RiskORE Part 1

A 6-year-old child has a newly erupted lower first permanent molar with deep pits and fissures. The child has caries in several primary teeth. Which preventive management is most appropriate for this molar?

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Correct answer: D — Place a resin fissure sealant once adequate isolation is possible

**A is correct.** This child has increased caries risk, indicated by caries in several primary teeth, and the new lower first permanent molar has deep fissures. SDCEP advises placing sealants in all pits and fissures of permanent molars as soon as possible after eruption for children at increased risk; resin-based sealant is first choice when isolation is feasible. Fluoride varnish remains an important additional preventive measure, but varnish alone is not the best option where fissure sealing is indicated and achievable. Review without sealing, or delaying until further eruption or the permanent dentition is complete, unnecessarily postpones effective prevention during a vulnerable period. Extraction has no indication in a sound newly erupted permanent molar. If the tooth were too partially erupted for moisture control, a temporary glass-ionomer sealant could be considered instead.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Management of Dental Caries in Children, 3rd edition: Professionally-delivered interventions (2025 update). https://www.childcaries.sdcep.org.uk/guidance/caries-prevention/professionally-delivered-interventions/