Fissure Sealant Indication — MFDS Part 1 MCQ
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Correct answer: B — A newly erupted permanent first molar with deep fissures in a child with active caries elsewhere
Explanation lettering: D = shown as A · A = shown as B · B = shown as C · E = shown as D · C = shown as E
A is correct. Current SDCEP guidance states that the decision to seal permanent molars is risk-dependent and that, in children at increased caries risk, all pits and fissures of permanent molars should be sealed as soon as possible after eruption. Deep fissures and active caries elsewhere strengthen the indication. Resin-based sealants are the first-choice material when adequate isolation is possible. A smooth primary incisor has no susceptible occlusal fissure, and an unerupted molar cannot yet be sealed. A cavitated dentinal lesion requires active caries management rather than a preventive sealant alone, although unaffected remaining fissures may subsequently be sealed. An intact restoration already covering the pits and fissures should be monitored rather than routinely sealed.
Reference: Scottish Dental Clinical Effectiveness Programme. Prevention and Management of Dental Caries in Children: Guidance in Brief, Third Edition, Caries prevention, pp. 10–11, 2025. https://www.childcaries.sdcep.org.uk/media/5p4fv1sf/sdcep-prevention-and-management-of-dental-caries-in-children-3rd-edition-guidance-in-brief.pdf