摘要：Aim: We attempted to assess the part care to the first permanent molars represents in total spending for dental care and to estimate the economic and medical advisability of using the pit and fissure sealing technique on the first permanent molars for the prevention of tooth decay. Method: We studied a representative sample of 2649 affiliates in the Nord – Pas-de-Calais and Picardie regions who were reimbursed for dental care on October 15, 1998. 54% of the patients in the sample (1437) were examined by a member of health care’s advisory dental staff. Results: The first permanent molars represent 28% of total reimbursed costs for care given to all the permanent teeth. 34% of all reimbursed conservative treatment for the first permanent molars concern patients under twenty years of age. In children aged 5 to 9 years who had reimbursed dental care, caries occurring on the occlusal side of the first permanent molars constitute 71% of all decayed or filled first molars. 47% of all patients in this age group have dental caries on the occlusal side of at least one permanent molar. 87% of their first molars present caries on the occlusal surface or have no tooth decay. We failed to find any correlation between dental decay on the occlusal surface and the socio-economic characteristics of the affiliates. Conclusion: All children between 5 and 9 years old do not require pit and fissure sealing for the prevention of dental caries on the occlusal surface of their first permanent molars. Before this technique is approved for reimbursement by health insurance, guidelines are needed for defining its indications.
