Can sealants be successfully placed over early carious lesions?

Sealants are designed to provide a protective barrier over healthy tooth surfaces, particularly in pits and fissures, to prevent decay. When it comes to early carious lesions, also known as incipient caries, placing sealants directly over these lesions is generally not recommended. This is because active carious lesions indicate the presence of bacteria and ongoing demineralization of the tooth structure. Applying a sealant over such lesions could potentially trap bacteria and moisture, leading to further progression of the decay beneath the sealant and complicating future restorative treatment.

Sealants are best used on sound enamel or areas that are free from decay, helping to maintain the tooth's integrity without encouraging further deterioration. Therefore, the practice of placing sealants over active carious lesions contradicts the principles of preventing further decay and maintaining oral health. In contrast, when the lesions are nearly healed, or if they are very minor, practitioners may assess the risk and make informed decisions regarding sealant placement but must always lean towards caution when dealing with any active carious conditions.